Date of Publication
2025
Project Team
Rebecca Nagle
Abstract
The prevalence of anxiety symptoms in children has been rising, driven by current social, cultural, and global factors. In response to this growing trend, the United States Preventive Services Task Force recommends universal anxiety screening for all children ages 8-18 years old without a prior diagnosis of anxiety. Despite this recommendation, and an increase in anxiety and depression rates among Vermont children (from 13.7% in 2016 to 19.2% in 2020), universal anxiety screening remains underutilized in one pediatric outpatient practice. This quality improvement project aimed to increase universal anxiety screening rates to 80% during well-child visits across three pediatric outpatient clinics in Vermont by December 2024. A sequential screening process was implemented, beginning with primary psychosocial screening using the Pediatric Symptom Checklist – 17 (PSC-17). Positive primary screens were followed by secondary targeted anxiety screening using the Screen for Child Anxiety Related Disorders (SCARED) or Generalized Anxiety Disorder – 7 (GAD-7) depending on age. A positive secondary screen prompted follow-up with a provider. Primary screening rates ranged from 66%-85%, with improvements observed across all clinics during the second Plan-Do-Study-Act (PDSA) cycle. Secondary screening rates ranged from 0%-33%, with two out of three clinics showing improvements. Documentation of follow-up plans varied from 50%-100%, also improving in all clinics by the second PDSA cycle. The percentage of positive primary screens ranged from 4%-13%, aligning closely with the national anxiety prevalence rate of 10%. These findings suggest that implementing a sequential screening process for universal anxiety screening is both feasible and beneficial in a pediatric outpatient setting.
Document Type
Dissertation/Thesis
Recommended Citation
Berman, Emma; Nagle, Rebecca; McKinley, Kari; and Veit, Alicia, "Implementing Universal Anxiety Screening for Children Ages 8-18 Years Old at a Pediatric Primary Care Practice" (2025). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 183.
https://scholarworks.uvm.edu/cnhsdnp/183
