Incorporating Behavioral Health Strategies in Primary Care to Improve Outcomes of Depressed Patients
Date of Award
Fall 11-18-2025
Document Type
Scholarly Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Dr. Sheri Jacobson, PhD, RN
Second Advisor
Dr. Bryleigh Carver, DNP, FNP-C
Abstract
Practice Problem: Depression, otherwise known as major depressive disorder, is a mood disorder characterized by persistent feelings of sadness, loss of interest, sleep disturbances, changes to weight (both gain and loss), difficulty concentrating, and in extreme cases, suicidal thoughts, and/or attempts (Mayo Clinic, 2022). An estimated 8.3% or 21.0 million adults in the United States have experienced at least one episode of depression. Primary care clinicians are often the first to recognize the symptoms of depression. Depression was very prevalent in the clinic where this DNP Scholarly project took place. The owner/nurse practitioner found that she was increasingly treating depressed patients with reduced availability to community support due to the limited access to providers in the area.
PICOT: The PICOT question that guided this DNP Scholarly project was, in adult patients aged 18 to 65 with a PHQ-9 score of greater than four (P), does utilizing the Mental Health Minnesota Coping Toolbox (I) compared to the current practice (C) improve PHQ-9 scores (O) over an 8-week period (T)?
Evidence: Screening for depression is the most effective way to identify patients with depressive symptoms that would have otherwise gone unreported (Dahne et al., 2025). Self-guided strategies are an easily accessible and cost-effective method of reducing depressive symptoms (Gou, 2023).
Intervention: The Mental Health Minnesota Coping Toolbox was the intervention identified for use in this DNP Scholarly project. The coping toolbox is a list of skills, techniques, items, and other suggestions a patient can use when facing symptoms of depression. There were eight categories containing different interventions: mood boosters, addressing the patient’s basic needs, processing the patient’s feelings, volunteering/acts of kindness, problem solving, hobbies/stress relievers, relaxation exercises, and asking for help.
Outcome: Outcome results showed the effectiveness of the project as 80% of participants who had pre- and post-intervention PHQ-9 scores showed reduced severity of depression, with an average reduction of depression greater than 40%.
Conclusion: Patients aged 18-65 who screened positive for at least mild depression (indicated by a PHQ-9 score of 4 or greater) and who utilized the Mental Health Minnesota Coping Toolbox showed a significant clinical improvement. The observed average reduction of greater than 40% aligns with clinically meaningful improvement in depression severity in participants who participated until re-evaluation.
Recommended Citation
Brummett, A. L. (2025). Incorporating Behavioral Health Strategies in Primary Care to Improve Outcomes of Depressed Patients. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.SSMR4909
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
Mental Disorders Commons, Other Psychiatry and Psychology Commons, Psychiatric and Mental Health Commons
Comments
Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.