Date of Publication


Project Team

Marcia Bosek, DNSc, RN


Background: Rates of anxiety among adolescents are increasing. Providers at a rural Vermont clinic identified the need for an evidence-based process to use when adolescents screen positive for anxiety. Reports from providers regarding the challenges of referring to mental health providers called the accessibility of care into question.

Purpose: The purposes of this quality improvement project are to create an evidence-based toolkit for adolescent anxiety and assess the accessibility of mental health care in Vermont.

Methods: A literature review identified mindfulness and exercise as effective tools for managing anxiety. An anxiety toolkit was designed for adolescents aged 11-18 years. Content was validated by a panel of independent reviewers using AHRQ’s PEMAT-P and assessed by adolescent volunteers for usefulness. An exploration of the mental health resources available in three Vermont counties was then compiled into a report.

Results: The toolkit was rated 100% on actionability and averaged 93.3% on understandability on the PEMAT-P. Overall, adolescent volunteers reported that they found the toolkit engaging and applicable. As for accessibility of care, 41% of private providers in the counties of interest were not accepting new patients at the time of the project. Those interviewed reported that COVID increased the incidence of adolescent anxiety, providers are overwhelmed, interagency communication requires improvement, and more mental health providers are needed in Vermont.

Conclusion: An evidence-based toolkit may empower adolescents to take charge of their mental health care at home. Action is needed to ensure that mental health resources in Vermont are timely, accessible, and affordable.

Document Type


Available for download on Wednesday, May 03, 2023

Included in

Nursing Commons