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Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin Martin Apr 2024

Individual Differences In Cannabis Use Disorder With Implications For Endocannabinoid Modulation In Therapeutics Development, Erin Martin

MUSC Theses and Dissertations

Cannabis use disorder (CUD) is increasingly prevalent in the United States, but there is no effective pharmacological means to treat it. The endocannabinoid (eCB) system has emerged as a candidate therapeutic target demonstrating some evidence of efficacy in treating CUD. However, clinical trials evaluating eCB-modulating therapeutics have historically undervalued individual differences that could contribute to variation in treatment outcome (e.g. sex, comorbid psychiatric illness). To address this gap in the literature, the present set of studies (a) compared plasma eCB tone in groups underrepresented in treatment trials for CUD (females, individuals with comorbid major depressive disorder; MDD/CUD) with males or …


Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson Mar 2024

Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson

University Honors Theses

In recent decades, research on the gut-brain axis has evolved due to an increasing interest in the connection between gut health and mental health. The gut-brain axis presents a new frontier of health for both medical professionals and psychologists as there is expanding evidence illustrating the comorbidity of gut disorders and mood disorders. Due to the complex nature of studying the gut-brain axis and the myriad of influences on mood disorders such as depression, research has yet to find significant results definitively tying the two together. Nonetheless, the current body of literature on the topic provides a promising outlook on …


The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane Jan 2024

The Relationship Between Self-Reported Depressive Symptoms At 3 Timepoints And Infant Sleep Practices At 6-Month Follow-Up In A Population Of Mothers In Santo Domingo, Ecuador, Kassidy Lane

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Background

Previous studies have linked maternal depression with poor infant sleep (e.g., waking up at night and infants having trouble settling to sleep). This study examined the relationship between maternal depressive symptoms at three time points and safe infant sleep at 6-month follow-up.

Methods

Data was collected from a randomized clinical trial including 100 women recruited from a health center in Santo Domingo, Ecuador during their third trimester of pregnancy. Log-binomial regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of safe infant sleeping at 6 months among mothers who reported depressive symptoms at 3 …


Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford Dec 2023

Traumatic Brain Injury Severity In Older Adults: Impact On Anxiety And Depression Symptoms And Community Engagement, Ashley Tomford

Theses and Graduate Projects

Background: Traumatic Brain Injury (TBI) is one of the leading causes of physical and cognitive disability worldwide. TBI can negatively impact cognitive, physical, social, and psychological functioning.

Objective: This study investigated interactions between TBI severity, mental health symptom severity, and community engagement among older adults. Specific aims included investigating 1) the relationship between TBI severity at the time of injury and psychiatric symptom severity at one-year post-TBI; 2) the relationship between TBI severity and community engagement at one-year post-TBI; and 3) whether mental health symptom severity moderated the relationship between TBI and post-injury community engagement.

Methods: Archival data was analyzed …


Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji Dec 2023

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …


Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez Dec 2023

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …


A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll Dec 2023

A Quality Improvement Project To Screen For Food Insecurity In Adults With Anxiety Or Depression, Kelsie Evelyn Kroll

Doctor of Nursing Practice

Background Food insecurity is the limited availability and inconsistent accessibility of healthy foods (Coleman-Jensen et al., 2022a). Food insecurity contributes to mental health problems. Individuals with food insecurity have greater odds of screening positive for depression and anxiety (Wolfson et al., 2021). The Hunger Vital Sign™ screening tool is a 2-questions evidence-based tool used to identify food insecurity (Hager et al., 2010). Purpose. Implement the Hunger Vital Sign™ tool at a non-profit behavior health clinic to identify food insecurity in adults who screened positive for anxiety or depression, offer resources for them to obtain nutritious food, and provide additional information …


Self-Reflections Through A Screen: Self-Identity, Social Media, And Psychological Well-Being, Jeremy J. Serio Dec 2023

Self-Reflections Through A Screen: Self-Identity, Social Media, And Psychological Well-Being, Jeremy J. Serio

Undergraduate Honors Thesis Collection

Social media use among emerging adults is assumed to be related to a variety of negative psychological outcomes and has, in recent years, become a widely studied phenomenon (Kim, 2017, Pew Research Center, 2018). Despite the widespread assumption, the results from empirical studies of the effects of social media use on mental health in this population have been inconsistent and inconclusive (Keles et al., 2020, Yang et al., 2021). Several meta-analyses (e.g., Keles et al., 2020) demonstrate these inconsistent results across studies and point to the need to consider individual difference factors when researching this issue. Different self-identity styles have …


Evaluating The Effects Of Ketamine On Cognitive Flexibility In Rats Using A Probabilistic Reversal Learning Task, Anthony N. Nist Dec 2023

Evaluating The Effects Of Ketamine On Cognitive Flexibility In Rats Using A Probabilistic Reversal Learning Task, Anthony N. Nist

All Graduate Theses and Dissertations, Fall 2023 to Present

Depression is one of the most debilitating and widespread mental health conditions in the world today. Drugs that are traditionally prescribed to combat depression are flawed in several ways, and because of this, new treatments are needed. One drug that seems capable of overcoming the limitations of traditional antidepressants is ketamine. In clinical research, a single dose of ketamine can significantly reduce symptoms of depression quickly, its effects may last for weeks to months, and its side effects appear to be limited and relatively harmless. However, clinical research is ongoing, and more research is needed to fully understand ketamine's beneficial …


Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson Nov 2023

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …


Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab Nov 2023

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …


Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor Nov 2023

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …


The Effects Of Mindfulness On Depression In Dialysis Patients, Nakeia Saddler Oct 2023

The Effects Of Mindfulness On Depression In Dialysis Patients, Nakeia Saddler

Dissertations

Abstract

Problem: Depression is a prevailing global health issue and a typical complication of dialysis patients. This quality improvement project's purpose was to evaluate mindfulness on depression in dialysis patients, aged 18-93, who are on dialysis and participated in a mindfulness program over three months.

Methods: A descriptive, prospective, and retrospective design was used to assess depression pre- and post-implementation of a mindfulness telephone line over three months. A convenience sample of twenty adults aged 18-83 who use this hemodialysis center on Monday, Wednesday, and Friday was utilized. The Iowa Model is the framework selected to guide the implementation of …


A Post Pandemic Analysis Of Covid-19 And The Impact On Mental Health Of High School Student-Athletes—Today, More Than Ever Minds Matter, Pastora Hernandez Barbee Aug 2023

A Post Pandemic Analysis Of Covid-19 And The Impact On Mental Health Of High School Student-Athletes—Today, More Than Ever Minds Matter, Pastora Hernandez Barbee

Ed.D. Dissertations in Practice

The cancellation of sporting opportunities during the COVID-19 pandemic caused many student-athletes to feel deprived of the only outlet they had, which held a significant component of their personal and athletic identities (Grubic et al. 2021). This study aimed to answer the following research question: What are the experiences of high school student-athletes in a Pacific Northwest school district with access and support for holistic wellness in a post-pandemic COVID-19 school environment? The research methodology used was the wellness theory framework (Adams, Bezner, & Steinhardt, 1997). A total of seven student-athletes participated in the study through in-depth interviews. From the …


Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa Aug 2023

Improving Health Outcomes Among Patients With Chf Through Implementation Of Telehealth Depression Screening And Chf Symptom Management, Akudo Udodiri Unanwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Comorbid congestive heart failure (CHF) and depressive disorder is a leading cause of mortality globally. Despite effective detection and therapeutic options, 30-day hospital readmission rates for CHF patients remain high, with patients experiencing adverse clinical outcomes and poorer quality of life. Depression is identified as a common comorbidity among CHF patients that may negatively impact patient self-care and adherence to a CHF treatment plan.

Problem: Telehealth applications are an increasingly utilized approach to healthcare delivery that enhances timely access to healthcare services by reducing physical proximity and transportation barriers to care. Currently, telehealth screening for CHF in the …


Evaluation Of Dirfloortime® On Mother’S Depression, Anxiety, And Stress, Hailey Vanderleest Jul 2023

Evaluation Of Dirfloortime® On Mother’S Depression, Anxiety, And Stress, Hailey Vanderleest

Dissertations

This paper reports the results of a retrospective record review and qualitative questionnaires of mothers of children with neurocognitive disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The aim was to examine the relationship between DIRFloortime® use in children with ASD and ADHD and PHQ-8 scores for depression, GAD-7 scores for anxiety, and PSS-10 scores for perceived stress among the children’s mothers. The results showed no statistical significance between DIRFloortime® use in children and PHQ-8, GAD-7, and PSS-10 scores for mothers. Qualitative questionnaires did report improvements in quality of life. Implications for the need of evidence-based developmental …


Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie Jul 2023

Implementation Of A Postpartum Depression Screening Protocol, Samantha Abercrombie

Doctor of Nursing Practice Projects

Background: Postpartum depression (PPD) is a major depressive disorder that can occur after having a baby and anytime during the first year postpartum (Centers for Disease Control and Prevention [CDC], 2021). Symptoms of PPD may include anger, crying more than usual, withdrawing from family, inability to bond with the baby, feelings of anxiousness, or thoughts of the mother harming herself or the baby. PPD can yield many challenges and hinder daily living activities. Recent research by the CDC (2021) estimates that 1 in 8 women experience manifestations of PPD. Findings also suggest that 1 in 5 women were not …


Incorporating A Depression Screening Tool With A Music Strategy For Depression In Adults Aged 50 And Older In An Ltc Facility, Margaret L. Hill Jul 2023

Incorporating A Depression Screening Tool With A Music Strategy For Depression In Adults Aged 50 And Older In An Ltc Facility, Margaret L. Hill

Doctor of Nursing Practice Projects

Background: Depression is not a normal part of life or the aging process. Unfortunately, older adults are at an increased risk of experiencing depressive symptoms. The global prevalence of major depression in older adults at 13.3%, and adults (70 and above) have a higher risk of depression compared to other age groups.

Purpose: The purpose of the DNP project was to improve patient outcomes through the implementation of depression screening and an adjunctive music strategy in older adults with depressive symptoms.

Methods: A pre, mid, and post-intervention was conducted in a long-term care facility. This author conducted a …


Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas Jul 2023

Implementation Of A Progressive Muscle Relaxation Intervention To Decrease Cancer Patients' Distress: A Quality Improvement Project., Theresa Thomas

Doctor of Nursing Practice Papers

Background: People affected by cancer often experience psychological distress that ultimately decreases their health, adherence to treatment, overall well-being, and quality of life. Research has shown that MBIs can reduce psychological distress, depression, and anxiety and increase quality of life. A needs assessment conducted within a local cancer support organization, Gilda’s Club Kentuckiana, has expressed the need for providing a more comprehensive range of accessible MBIs in their programming to meet their psychosocial goals by reducing psychological distress in their members. PMR is an MBI not currently used by GCK that has been proven effective at reducing anxiety, depression, and …


Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov May 2023

Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov

Doctor of Nursing Practice Final Manuscripts

Introduction: This Evidence-Based Practice Doctor of Nursing Practice project aimed to implement a nurse-led post-stroke depression (PSD) screening using Patient Health Queastionnaire-9 (PHQ-9) in a 12-bed progressive care neuro-stroke unit at a tertiary care hospital. The first goal of this project was to detect stroke patients at risk for depression who met specific inclusion criteria. The second goal was to provide depression education, initiate social work and medical referrals, and start pharmacological treatment to reduce the medical and socioeconomic burden associated with untreated PSD before discharge from the hospital.

Background: Globally, stroke is a prominent cause of death and disability. …


Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar May 2023

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …


Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace May 2023

Exercise As A Prescription For Patients With Depressive Disorders: A Quality Improvement Project, Sydney Roscoe, Rachelle Pace

Doctor of Nursing Practice Final Manuscripts

Purpose: The aim of this Doctor of Nursing Practice project was to increase exercise counseling rates in the treatment of depression by (1) implementing a focused educational training program and (2) understanding factors that impacted utilization of the practice change.

Background: Approximately 280 million individuals suffer globally from depressive disorders. Depression remains the fourth leading cause of disabilities, significantly contributing toward the global burden of disease by increasing morbidity and mortality risk. Psychopharmacology and psychotherapy are current gold standards of treatment; however, providers often overlook the significant role exercise serves in reducing depressive symptoms and severity, as it remains underutilized. …


Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel May 2023

Mental Health Among D1 Female College Athletes: Prevalance And Links To Athletic And Academic Performance, Mary Goebel

Honors Theses

Background. NCAA Division I female student-athletes are underrepresented in mental health research; existing research among female athletes tends to focus only on disordered eating and body appearance. This study aims to 1) describe the prevalence of mental health issues (i.e., anxiety, depression, and stress) among female Division I college athletes, and 2) assess the association between mental health issues and the student-athlete experience (i.e., athletic and academic performance).

Methods. This was a quantitative, cross-sectional study that used a self-administered online survey. The participants were NCAA Division I female student-athletes, mainly from the University of Mississippi. Demographics and sample characteristics were …


The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin May 2023

The Associations Between Adolescent Motives For Social Media Use With Body Dysmorphia, Eating Disorder, And Anxiety And Depression Symptoms, Kaylan Melvin

Honors Theses

Adolescents spend a large amount of time on social media sites. This is notable, as adolescence is a crucial time for body image development. Additionally, recent findings suggest that using image-oriented social media sites, such as Facebook and Instagram, is associated with more body dissatisfaction and disordered eating. Among previous studies, certain social media motivations have been found to have an association with poor body satisfaction and well-being in adolescents. To our knowledge, no studies have directly examined the association between social media motivations and eating disorder, body dysmorphic disorder, and anxiety and depression symptoms in adolescents. The current study …


A Study Of First-Generation College Students At The University Of Mississippi, Brady Suttles May 2023

A Study Of First-Generation College Students At The University Of Mississippi, Brady Suttles

Honors Theses

First-generation college students (FGCS) are a distinct sub-population within higher education. In comparison to their peers, FGCS report increased levels of anxiety, depression, and stress along with lower levels of social support and academic attainment. Considering the unique context and history of the University of Mississippi (UM), it is crucial to understand the specific needs of FGCS enrolled at UM. The aims of this study were to: 1) assess the associations between FGCS status and mental health and academic achievement, and 2) determine whether sense of belonging moderates these associations.

First-generation college students had higher mean levels of depression symptoms …


Links Between Mental Health And Employment Outcomes Among Adults With Autism Spectrum Disorder, Emma Atkinson May 2023

Links Between Mental Health And Employment Outcomes Among Adults With Autism Spectrum Disorder, Emma Atkinson

Honors Theses

Problem: Mental health outcomes related to Autism Spectrum Disorder (ASD) have been extensively researched, although most research in the area is on children with ASD. Studies on adults with ASD are scarcer. More specifically, studies that analyze the association between mental health and work-life balance (WLB) as well as mental health and job satisfaction (JS) among employed adults with ASD is limited. The purpose of this study was to analyze the association between mental health and WLB among adults with ASD, the association between mental health and perceived JS among adults with ASD, and whether or not ASD severity moderates …


Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi May 2023

Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi

Doctor of Nursing Practice Projects

Abstract

Digital therapy is a growing healthcare intervention improving limited access to specialty care for specific populations and geographic areas. Cognitive Behavioral Therapy (CBT) applications focus on treating anxiety and depression and assist pediatric and adolescent patients in learning behavioral techniques as they wait for 3-6 months or longer to see a mental health provider. Such delays are attributed to the national shortage of mental health practitioners and the further scarcity of fewer psychiatric providers in rural areas, causing the potential for adverse patient outcomes. The setting for this 8-week quality improvement project was a pediatric care clinic that sees …


Improving Depression Remission Screening Compliance, Crystal Wingerter May 2023

Improving Depression Remission Screening Compliance, Crystal Wingerter

Doctor of Nursing Practice Projects

Depressive disorders are widespread in the United States and are diagnosed and treated in the primary care setting. In 2019, there were an estimated 19.4 million adults that had at least one major depressive episode. The purpose of this project was to improve follow up and depression remission assessment for patients with a diagnosis of depression at a metropolitan family care practice clinic. The Patient Health Questionnaire (PHQ–9) was utilized for remission assessment. Front desk staff and providers were trained and granted access to the quality information system (QIS) in the electronic medical records (EMR) system which allowed easy identification …


Examining The Relationship Between Cigarette Smoking And Depression Among Asian American Adults, Connor Aitken May 2023

Examining The Relationship Between Cigarette Smoking And Depression Among Asian American Adults, Connor Aitken

Self-Determined Majors Final Projects

Does having smoked cigarettes have any relationship to depression? This study explores the relationship between cigarette smoking and depressive frequency within the Asian American adult population. I hypothesized that Asian American adults who have ever smoked a cigarette would report more depression compared to Asian American adults who have never smoked cigarettes. To test this hypothesis, I analyzed data from the 2021 National Health Interview Survey (NHIS) using a subset of 1704 Asian American adults aged 18 to 85+. I controlled for native-born status, social/emotional support, relationship status, education, age, and gender. Controlling for the other variables, Asian American adults …


Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska May 2023

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …