84 - Implementing Anxiety Screening to Identify Mental Health Needs in Adolescents: A Quality Improvement Initiative

Publication Number: 4082.84

Amanda Gogol-Tagliaferro, Akron Children's Hospital, Brecksville, OH, United States

Background: Anxiety disorders are some of the most prevalent childhood-onset psychiatric conditions, with prevalence rates ranging from 10% to 30%. In alignment with USPSTF Bright Futures guidelines, a quality improvement initiative was undertaken to introduce routine anxiety screening for adolescents aged 12 years and older during well-check visits in a primary care setting.

Objective: Increase the percentage of youth ages >= 12 screened for anxiety at well checks from 0 to 80% by August 1, 2025.

Design/Methods: The project was conducted in a Federally Qualified Health Center (FQHC) affiliated with a larger network of over 40 outpatient offices within a Midwestern pediatric hospital system. Using the Model for Improvement as a framework, our team implemented the GAD-7 screening tool via automated Patient Entered Questionnaires at adolescent well checks. Clinical decision support alerts and pre-checked orders were tested and refined through Plan-Do-Study-Act (PDSA) cycles to enhance screening processes. The primary outcome measure was the percentage of eligible patients screened, while a secondary measure focused on identifying patients with GAD-7 scores ≥10, suggesting potential anxiety disorders.

Results: Between December 2024 and August 2025, 884 eligible adolescent patients attended well-check visits. Of these, 81% (718) were screened for anxiety using the GAD-7. Among those screened, 10.5% (74) had a GAD-7 score of 10 or higher, which suggests the presence of a potential anxiety disorder.

Conclusion(s): Routine anxiety screening during adolescent checkups can be implemented efficiently as part of well visits. Further research will explore interventions for individuals with positive screens and broaden screening across the network.

Control Chart (p-type) of QI Process