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Enhancing Anxiety Screening and Early Intervention in Adolescent Primary Care
Nguyen, Anna Martin, Lili
Nguyen, Anna
Martin, Lili
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Abstract
Adolescent anxiety is highly prevalent, increasingly burdensome, and often under-identified in primary care, especially following the COVID-19 pandemic. Despite national screening recommendations, implementation remains inconsistent and follow-up after positive screens is often unstandardized. This quality improvement project aimed to improve the detection and initial management of adolescent anxiety in a Vermont family medicine clinic by expanding routine anxiety screening and distributing a validated, evidence-based anxiety toolkit focused on mindfulness, exercise, and self-management resources. A 12-week initiative, implemented from August to November 2025, extended Generalized Anxiety Disorder-7 (GAD-7) screening to adolescents aged 11-19 presenting for Well Child, New Patient, and Established Patient Visits ≥ 30 minutes. Adolescents with GAD-7 scores ≥ 5 were offered the toolkit. Outcome measures included screening completion rates, prevalence of positive screens, and toolkit distribution rates collected via the electronic health record extraction and provider surveys. Of 62 eligible adolescent visits, 64.5% (n=40) completed GAD-7 screening and 23% (n=9) screened positive for anxiety. 67% (n=6) of the positive screens received the toolkit. Screening occurred most frequently during Well Child Visits. Providers (n=4) reported strong clinical value but noted variability in workflow integration, documentation burden, and follow-through. Findings suggest expanded screening is feasible and valuable, especially in preventive care workflows. However, inconsistent uptake and follow-up highlight the need for clearer workflow prompts and standardized post-screen pathways. Pairing screening with immediate, low-cost psychoeducation may improve early intervention and guide future quality improvement efforts.
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2026-04-26
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Nguyen_DNP_Manuscript_2026.pdf
Adobe PDF, 2.39 MB
- Embargoed until 2027-04-26
Nguyen_QIPoster.pdf
Adobe PDF, 867.89 KB
- Embargoed until 2027-04-26