Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation Training, Assessment, Policy/Guideline (National)

Intervention Description: In an effort to document state and jurisdiction activity in National Performance Measure 6 (NPM 6), AMCHP conducted an environmental scan of Title V program developmental screening activities. AMCHP obtained information through the Title V Information System (TVIS) by filtering Title V programs that chose NPM 6 and reviewing the narrative and action plans to ascertain their NPM 6 strategies, their accompanying evidence-based/informed strategy measures (ESMs), and related challenges. Information included in this issue brief does not represent an exhaustive list of each state’s and jurisdiction’s developmental screening activity, nor is every state or jurisdiction that is implementing the strategies mentioned. However, the range of strategies presented and the states and jurisdictions referenced here provide a snapshot of Title V program approaches, strategies, and techniques being used to increase developmental screening rates.

Intervention Results: The environmental scan of TVIS revealed that 41 states and jurisdictions chose NPM 6. As previously mentioned, Title V programs also have the option to select a State Performance Measure (SPM) based on results from their state’s needs assessment. Ten of the 41 states and jurisdictions that chose NPM 6 also selected an SPM related to developmental screening. The scan also found four states that did not choose NPM 6, but did select an SPM related to developmental screening. The environmental scan revealed a wide range of NPM 6 strategies and activities, under the following categories: • Policy Research, Development and Implementation • Systems Coordination 3 • Data Collection, Measurement and Existing Landscape • Technical Assistance and Training • Education, Engagement and Resource Development • Other Title V Program Strategies

Conclusion: information on Title V program activities related to NPM 6. These data provide insight into identified needs in policy, systems coordination, training, data integration, as well as strategies to address these needs. The selected examples highlighted within each category may prove useful to other Title V programs as they implement developmental screening-related strategies and measures to build or improve systems of care for children. In coming years, NPM 6 data can be analyzed more in-depth to develop resources such as reports, toolkits, or guides to assist Title V programs with developmental screening and early identification system challenges. These data will also guide AMCHP’s efforts to create meaningful technical assistance opportunities including webinars, learning modules, conference sessions, and other in-person trainings, to help states in advancing NPM 6. These resources will expand the repository of promising policies and practices featured on the State Public Health Autism Resource Center website (http://www.amchp.org/SPHARC), which is accessible to all Title V programs and their state and national partners.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (National), Educational Material, Screening Tool Implementation Training

Intervention Description: The document outlines national consensus standards for developing comprehensive, quality systems of care for children and youth with special health care needs (CYSHCN). The standards cover 10 core domains including screening/assessment, eligibility/enrollment, access to care, the medical home model, community-based services, family partnerships, transition to adulthood, health IT, quality assurance, and insurance/financing. Specific structural and process standards are provided for each domain, synthesized from existing frameworks, federal requirements, and input from a national workgroup of experts and stakeholders. The standards are intended for use by state programs, health plans, providers, and others serving CYSHCN.

Intervention Results: The document does not present results per se, but rather provides the full set of consensus-based system standards across the 10 core domains. Detailed standards are outlined related to components like screening processes, care coordination, access to pediatric specialty care, respite care, transition planning, health IT capabilities, quality measurement, and adequate insurance coverage and financing for needed services. Relevant existing national principles, frameworks, federal laws, and quality measures are cited for each domain.

Conclusion: The standards presented are designed to guide national, state and local stakeholders in achieving comprehensive, quality systems of care to improve health outcomes for the CYSHCN population. They are intended to supplement and align with existing federal requirements, evidence-based principles, and quality metrics. The document concludes that consensus around these core system standards is essential as states extend insurance coverage, design benefits, and implement quality initiatives affecting CYSHCN under the Affordable Care Act and other reforms. Widespread application of the standards across systems serving CYSHCN is recommended.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Participation Incentives, Quality Improvement/Practice-Wide Intervention, Expert Support (Provider), Modified Billing Practices, Data Collection Training for Staff, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Expert Feedback Using the Plan-Do-Study-Act-Tool, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), Engagement with Payers, STATE, POPULATION-BASED SYSTEMS, Audit/Attestation, HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation (Provider)

Intervention Description: The Vermont Child Health Improvement Program (VCHIP) at the University of Vermont collaborated with state agencies and professional societies to conduct a survey of Vermont pediatric and family medicine practices regarding their developmental screening and autism screening processes, referral patterns, and barriers. The survey was administered in 2009 to 103 primary care practices, with a 65% response rate (89% for pediatric practices, 53% for family medicine practices).

Intervention Results: The survey results revealed that while 88% of practices have a specific approach to developmental surveillance and 87% perform developmental screening, only 1 in 4 use structured tools with good psychometric properties. Autism screening was performed by 59% of practices, with most using the M-CHAT or CHAT tool and screening most commonly at the 18-month visit. When concerns were identified, 72% referred to a developmental pediatrician and over 50% to early intervention. Key barriers to both developmental and autism screening were lack of time, staff, and training. Over 80% of practices used a note in the patient chart to track at-risk children, and most commonly referred to child development clinics, audiology, early intervention, and pediatric specialists.

Conclusion: The survey conducted by VCHIP revealed wide variation in developmental and autism screening practices among Vermont pediatric and family medicine practices. While most practices conduct some form of screening, there is room for improvement in the use of validated tools, adherence to recommended screening ages, and implementation of office systems for tracking at-risk children. The survey identified knowledge gaps and barriers that can be addressed through quality improvement initiatives, which most respondents expressed interest in participating in.

Study Design: QE: pretest-posttest

Setting: Pediatric and family medicine practices in Vermont

Population of Focus: Children up to age 3

Data Source: Child medical record; ProPHDS Survey

Sample Size: Chart audits at 37 baseline and 35 follow-up sites (n=30 per site) Baseline charts (n=1381) - Children 19-23 months (n=697) - Children 31-35 months (n=684) Follow-up charts (n=1301) - Children 19-23 months (n=646) - Children 31-35 months (n=655)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention, Provider Training/Education, Screening Tool Implementation,

Intervention Description: The intervention is the implementation of a screening protocol for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) and referral to a licensed professional clinical counselor for mothers who score 10 or higher on the EPDS . The intervention aligns with a discernable strategy of using the Institute for Healthcare Improvement’s (IHI) Plan-Do-Study-Act cycle as a guiding framework to plan, implement, evaluate, and modify changes to achieve outcome objectives .

Intervention Results: The study found that the implementation of the PPD screening and referral process resulted in a 24% detection rate for postpartum depression, which is approximately double that of the general population . The project reduced common barriers to PPD treatment, such as cost, transportation, and childcare issues . The RNs who participated in the project reported that the educational content provided them with the necessary information to successfully implement the PPD screening and referral process . The study also found that 80% of RNs reviewed the slide presentation by the project start date .

Conclusion: This project recognizes the importance of an interdisciplinary care approach and highlights the need for early identification and treatment for PPD among mothers with babies in the NICU. The project can guide future initiatives to increase the use of screening in the inpatient setting, to detect PPD during its early and more treatable stages.

Study Design: The study design used in the research is not explicitly stated, but it appears to be a quality improvement project aimed at implementing a routine postpartum depression (PPD) screening protocol in the Neonatal Intensive Care Unit (NICU) . The study used a one-group, posttest-only design to evaluate outcome objectives

Setting: The setting for the study is not explicitly stated in any of the given texts. However, it is mentioned that IRB review and waiver were obtained from both the academic institution and the hospital site . Additionally, the study focuses on screening mothers of babies in the Neonatal Intensive Care Unit (NICU)

Population of Focus: The target audience for the study appears to be healthcare providers who work with mothers of babies in the Neonatal Intensive Care Unit (NICU) and are interested in implementing a routine postpartum depression (PPD) screening protocol. The study provides information on the use of the Edinburgh Postnatal Depression Scale (EPDS) for identifying mothers at risk for PPD, as well as recommendations for education and referral to licensed professional clinical counselors

Sample Size: The sample size for the study is 25 mothers who received the screening

Age Range: The age group of the mothers who received the screening is not mentioned in the given texts

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Referrals,

Intervention Description: The intervention involved a quality improvement initiative aimed at addressing social drivers of health (SDoH), socioemotional development, and perinatal depression in pediatric practices through practice and system improvement. The Addressing Social Health and Early Childhood Wellness (ASHEW) project provided a framework for successful development and efficient integration of screening and referral processes into clinic workflow. It involved implementing Plan-Do-Study-Act cycles, monthly chart reviews, and collaborative meetings to facilitate increased documentation of screening, counseling, and referral for positive SDoH screens in participating practices. The project promoted a team-based approach that allowed individual practices to implement screening and referral practices using available staff and documentation and referral processes they had available.

Intervention Results: Measures showed significant improvements in SDoH screening and identified opportunities for improvement in the care continuum. SDoH screenings of eligible patients significantly increased from 21% to 62% on average ( p = 0.0002). Needed referrals fulfilled increased from 37% to 57% ( p = 0.003) on average. Interestingly, no significant improvement was seen in referring patients who screened positive (81% vs 89%, p = 0.0949).

Conclusion: Yes, the study reported statistically significant findings. The percentage of needed referrals fulfilled significantly increased over time for all practices involved in the study (37%–57%, p = 0.003). Additionally, SDoH screenings of eligible patients significantly increased from 21% to 62% on average (p = 0.0002). These findings indicate significant improvements in the screening and referral processes for social drivers of health in the participating pediatric practices.

Study Design: The study design/type is a quality improvement initiative. The Indiana Chapter of the American Academy of Pediatrics (INAAP) participated in a national quality improvement project led by the AAP called Addressing Social Health and Early Childhood Wellness (ASHEW), which sought to screen for and address social drivers of health (SDoH), socioemotional development, and perinatal depression in pediatric practices through practice and system improvement. The study evaluated the positive SDoH screenings and subsequent referrals from participating Indiana practices.

Setting: The setting for the study was pediatric practices in mid-central Indiana. Ten pediatric practices in this region participated in the collaboration between July 2020 and July 2021 as part of the quality improvement project led by the American Academy of Pediatrics (AAP).

Population of Focus: The target audience for the study includes healthcare professionals, pediatricians, and practitioners involved in pediatric care, as well as individuals and organizations interested in quality improvement initiatives related to addressing social drivers of health, socioemotional development, and perinatal depression in pediatric practices. Additionally, policymakers and researchers focusing on pediatric healthcare and social determinants of health may also find the study relevant.

Sample Size: The study involved ten pediatric practices in mid-central Indiana that participated in the collaboration between July 2020 and July 2021. Therefore, the sample size for the study was ten pediatric practices.

Age Range: The PDF file does not specify the age group of the patients who were screened for social drivers of health in the participating pediatric practices. However, it is mentioned that the project aimed to address social drivers of health, socioemotional development, and perinatal depression in pediatric practices. Therefore, it is likely that the age group includes infants, children, and adolescents.

Intervention Components (click on component to see a list of all articles that use that intervention): Health_Care_Provider_Practice, Screening Tool Implementation Training, Provider Training/Education

Intervention Description: Twenty-eight pediatricians completed an in-person meeting, monthly webinars, and individualized feedback from an Expert Work Group on progress across a 3-month action period.

Intervention Results: Statistically significant increases were observed in rates of autism screening, discussions of screening results with families, and referral following abnormal results. There was no statistically significant change in rates of general developmental screening. Comparing self-report with record review, pediatricians overestimated the extent to which they conducted discussion and referral.

Conclusion: Universal screening for all children has yet to be achieved. The current project supports that practice-based improvements can be made and delineates some of the routes to success.

Setting: Clinical practice

Population of Focus: Primary care peditricians

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention includes incorporating reminders for PPD screening into daily nursing rounds, coordinating referrals and follow-up for mothers with positive screenings, and involving the medical team in ensuring mothers receive the necessary resources . Additionally, the project involved developing a referral algorithm for NICU staff to follow when scoring the EPDS and a referral resource packet to be given to mothers with positive PPD screenings . The intervention aligns with a discernible strategy by addressing the identified limitations, such as lack of compliance, lack of comfort among nurses regarding EPDS administration, lack of mental health support within the hospital, screening gaps due to language barriers, and lack of electronic medical record (EMR) integration. The project aimed to increase the identification of maternal PPD symptoms and develop a referral algorithm and resource packet to support mothers with positive screenings . The project aimed to develop and implement a routine PPD screening program and evaluate its impact on the identification of maternal PPD symptoms

Intervention Results: The study concludes that routine maternal PPD screening should be implemented in all NICU settings. The findings of the study suggest that PPD recognition and subsequent intervention can be successful within the NICU setting. Furthermore, the literature highlighted the importance of having accessible resources in place for mothers who screen positive for PPD prior to the start of screening administration. The study also emphasizes the importance of having effective interventions in place for mothers who screened positive for PPD to promote optimal outcomes and program sustainability.

Conclusion: Routine maternal PPD screening should be implemented in all NICU settings. Postpartum mental health issues should not be the sole responsibility of obstetricians, mental health providers, or maternal primary care providers.

Study Design: The study is described as a pilot program evaluation project, which suggests that it is an observational study designed to assess the effectiveness and outcomes of implementing a routine PPD screening program in the NICU setting. The project aimed to increase the identification of maternal PPD symptoms and develop a referral algorithm for NICU staff to follow when scoring the EPDS.

Setting: The study was conducted in an 82-bed level IV Neonatal Intensive Care Unit (NICU) that provides critical care to over 700 neonates annually. This NICU is the only level IV NICU in the state and serves as a regional center that accepts complex cases and provides the highest level of care for critically ill neonates. The healthcare team within the NICU includes neonatologists, neonatology fellows, pediatric residents, neonatal nurse practitioners, registered nurses, respiratory therapists, pharmacists, dieticians, case managers, social workers, and lactation consultants. The organization has been recognized as a Magnet hospital by the American Nurses Credentialing Center and is known for its excellence in nursing practice, collaborative environment, and interdisciplinary approach.

Population of Focus: The target audience of the study is healthcare professionals, particularly those working in the neonatal intensive care unit (NICU) setting. The study emphasizes the importance of routine maternal PPD screening in the NICU setting and provides recommendations for implementing such screening programs. The study also highlights the need for accessible resources and effective interventions for mothers who screen positive for PPD. The findings of the study may be of interest to healthcare professionals involved in maternal and neonatal care, including nurses, physicians, social workers, and other members of the healthcare team.

Sample Size: The study did not report a specific sample size for the project evaluation. However, the population of interest included mothers of infants admitted to the NICU for a duration of at least 2 weeks. Exclusion criteria included mothers whose infants were admitted to the NICU for less than 2 weeks, adoptive mothers who did not give birth to the infant, and mothers who chose not to complete the screening tool. The study reported a total of 104 EPDS screenings completed over a 5-month period, with 27 mothers screening positive for PPD symptoms.

Age Range: The study did not explicitly mention the specific age range of the mothers included in the sample. However, it reported that 7% of the women with positive screenings were younger than 20 years, 33.3% were between 20 and 29 years old, 44.4% were between 30 and 39 years old, and 7% were 40 years or older. Additionally, the maternal age of 7% was unknown. This suggests that the sample included mothers across a range of ages, with a significant proportion falling within the 20-39 age range.

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Health Centers, Screening Tool Implementation,

Intervention Description: The study describes the implementation of a Screening, Monitoring, and Referral to Treatment (SMARTT) initiative at an urban middle school-based health center. The initiative involved the use of the Pediatric Symptom Checklist-17-Youth (PSC-17-Y) as a screening tool to identify adolescents at risk for mental health conditions. Adolescents who screened positive or had other identified clinical concerns were offered an on-site mental health referral. Referral outcomes were recorded, and adolescents who accepted referrals were tracked for follow-up visits.

Intervention Results: One out of four adolescents had a positive PSC-17-Y or negative screen with other identified concerns. Approximately half of these at-risk adolescents accepted a mental health referral, and 86% of those who declined agreed to the PCM visit. More than two-thirds of the PCM group did not need continued monitoring and support at follow-up, and 85.4% of youth who had a mental health assessment accepted mental health services.

Conclusion: Yes, there were statistically significant findings in the study. For example, younger adolescents (10-11 years old) were less likely to have a positive PSC-ES compared to 12-year-old adolescents (p = .021) and 13-year-old adolescents (p = .0004). In addition, younger adolescents were less likely to have a positive total score on the PSC-17-Y compared to 12-year-old adolescents (p = .0026) and 13-year-old adolescents (p = .0091). Furthermore, individuals with a positive PSC-17-Y total score (p = .013) and those with a positive PSC-17-Y in one subscale plus the total score (p = .050) were more likely to accept an on-site mental health referral than those with a negative score but with other concerns.

Study Design: The study design was a retrospective chart review of electronic health records and corresponding clinical tracking data.

Setting: The study was conducted in an urban school-based health center (SBHC).

Population of Focus: The target audience for this study includes healthcare providers, educators, and policymakers who are interested in improving access to and utilization of mental health services for young adolescents in school-based health centers.

Sample Size: The study included a total sample size of 741 adolescents.

Age Range: The age group of the adolescents in this study ranged from 10 to 16 years old, with a mean age of 12.2 years old.

Intervention Components (click on component to see a list of all articles that use that intervention): Training, Screening Tool Implementation,

Intervention Description: The intervention described in the article is the implementation of PPD screening using the two-item Patient Health Questionnaire (PHQ-2) followed by the nine-item PHQ (PHQ-9) and the Edinburgh Postnatal Depression Scale for those who scored 2 or greater on the PHQ-2. Participants who scored 10 or greater on the PHQ-9 or Edinburgh Postnatal Depression Scale were referred for case management services.

Intervention Results: The study found that participants with no health insurance and limited support in caring for their infants were more likely to report symptoms of PPD. Overall, 302 women were screened for PPD, indicating the feasibility of PPD screening in WIC clinics. Of the 19 participants referred to case management, 47% (n = 9) accessed care. The results of focus groups illuminated barriers to screening and treatment programs for women at the individual, local, and macrosystem levels. The study concludes that while PPD screening in WIC clinics is feasible, some participants did not receive mental health services after referral because of various barriers, which highlights the need to integrate mental health providers into WIC clinics

Conclusion: Our findings show the feasibility of PPD screening in WIC clinics. However, some participants did not receive mental health services after referral because of various barriers, which highlights the need to integrate mental health providers into WIC clinics.

Study Design: The study design is a descriptive, cross-sectional study followed by a process evaluation

Setting: The study was conducted in Charlotte, North Carolina, in two Mecklenburg County Public Health WIC clinics

Population of Focus: The target audience for the study is women older than 18 years with infants younger than 12 months who were visiting WIC clinics, as well as case managers, nutritionists, advisory board members, and students who served as research assistants

Sample Size: The initial sample size was 302 women older than 18 years with infants younger than 12 months who were visiting WIC clinics, and the second group included case managers, nutritionists, advisory board members, and students who served as research assistants (n = 31)

Age Range: The age group of the participants is women older than 18 years with infants younger than 12 months who were visiting WIC clinics

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Educational Material (caregiver), Quality Improvement,

Intervention Description: The intervention described in the article is the implementation of the Edinburgh Postnatal Depression Scale (EPDS) screening tool at two primary care pediatric clinics in an urban, multicultural, low socioeconomic immigrant community in San Diego, United States of America. The EPDS screening was conducted at the 2-week weight check and 1-, 2-, and 4-month well-baby visits. For mothers with positive screens, providers referred them to mental health care and updated their child’s electronic health record diagnosis to prompt reassessment for future visits. Educational materials were also created for patients and clinic staff about the significant impact PPD can have on infants and their development.

Intervention Results: Of the 523 eligible visits, 437 (83.5%) were screened using the EPDS tool and documented into the EHR. The overall incidence rate of at-risk mothers for PPD was 9.5%. Of those mothers who screened positive, 73.1% had documentation demonstrating a referral to mental health services. 63.2% of mothers referred attended their mental health appointments.

Conclusion: This project successfully implemented the American Academy of Pediatrics PPD screening guidelines and could be applicable to other pediatric outpatient settings.

Study Design: The PDF file does not explicitly state the study design or type. However, it is described as an evidence-based practice (EBP) project, which suggests that it is a quality improvement initiative aimed at implementing a specific intervention (in this case, PPD screening) in a real-world clinical setting. The project used the Iowa Model, which is a framework for implementing evidence-based practice changes in healthcare settings.

Setting: The evidence-based practice project was implemented at two primary care pediatric clinics in an urban, multicultural, low socioeconomic immigrant community in San Diego, United States of America

Population of Focus: The target audience for this study is healthcare providers and professionals who work in pediatric primary care clinics, particularly those serving immigrant and low-income populations.

Sample Size: The PDF file does not provide a specific sample size for the study. However, it does mention that the clinics served a lower socioeconomic pediatric population, and the majority (85%) of infants were insured by Medicaid. Additionally, provides some data on the number of mothers who were screened and followed up at the clinics, but it does not provide a total sample size for the study.

Age Range: The study focuses on infants and their mothers in the postpartum period. The screening for postpartum depression (PPD) was conducted during well-child visits for infants aged 1-6 months, with a focus on the 2-week visit and deferral of screening at the 6-month visit. The follow-up data in Table 2 is presented for infants at 12 months of age, which suggests that the study followed infants and their mothers for at least a year.

Intervention Components (click on component to see a list of all articles that use that intervention): EMR Reminder, Screening Tool Implementation,

Intervention Description: Children with health insurance have increased access to healthcare and receive higher quality care. However, despite recent initiatives expanding children's coverage, many remain uninsured. New technologies present opportunities for helping clinics provide enrollment support for patients. We developed and tested electronic health record (EHR)-based tools to help clinics provide children's insurance assistance. We used mixed methods to understand tool adoption, and to assess impact of tool use on insurance coverage, healthcare utilization, and receipt of recommended care. We conducted intent-to-treat (ITT) analyses comparing pediatric patients in 4 intervention clinics (n = 15,024) to those at 4 matched control clinics (n = 12,227). We conducted effect-of-treatment-on-the-treated (ETOT) analyses comparing intervention clinic patients with tool use (n = 2240) to intervention clinic patients without tool use (n = 12,784).

Intervention Results: Tools were used for only 15% of eligible patients. Qualitative data indicated that tool adoption was limited by: (1) concurrent initiatives that duplicated the work associated with the tools, and (2) inability to obtain accurate insurance coverage data and end dates. The ITT analyses showed that intervention clinic patients had higher odds of gaining insurance coverage (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [95% Cl] 1.14-1.51) and lower odds of losing coverage (aOR = 0.77, 95% Cl 0.68-0.88), compared to control clinic patients. Similarly, ETOT findings showed that intervention clinic patients with tool use had higher odds of gaining insurance (aOR = 1.83, 95% Cl 1.64-2.04) and lower odds of losing coverage (aOR = 0.70, 95% Cl 0.53-0.91), compared to patients without tool use. The ETOT analyses also showed higher rates of receipt of return visits, well-child visits, and several immunizations among patients for whom the tools were used.

Conclusion: This pragmatic trial, the first to evaluate EHR-based insurance assistance tools, suggests that it is feasible to create and implement tools that help clinics provide insurance enrollment support to pediatric patients. While ITT findings were limited by low rates of tool use, ITT and ETOT findings suggest tool use was associated with better odds of gaining and keeping coverage. Further, ETOT findings suggest that use of such tools may positively impact healthcare utilization and quality of pediatric care.

Study Design: Mixed methods study

Setting: Eight community health centers (CHCs) in Oregon

Population of Focus: Pediatric patients who were eligible for Medicaid or the Children's Health Insurance Program (CHIP), were at risk of being uninsured, and who received care at the community health centers (CHCs)

Sample Size: 15,024 pediatric patients (7,918 were from intervention clinics and 7,106 from control clinics

Age Range: Children and youth ages 0-19 years

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Participation Incentives, Modified Billing Practices, Data Collection Training for Staff, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Expert Feedback Using the Plan-Do-Study-Act-Tool, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), Engagement with Payers, STATE, POPULATION-BASED SYSTEMS, Audit/Attestation, HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation (Provider)

Intervention Description: Early identification of children with developmental and behavioral delays is important in primary care practice, and well-child visits provide an ideal opportunity to engage parents and perform periodic screening. Integration of this activity into office process and flow is necessary for making screening a routine and consistent part of primary care practice.

Intervention Results: In the North Carolina Assuring Better Child Health and Development Project, careful attention to and training for office process has resulted in a significant increase in screening rates to >70% of the designated well-child visits. The data from the project prompted a change in Medicaid policy, and screening is now statewide in primary practices that perform Early Periodic Screening, Diagnosis, and Treatment examinations.

Conclusion: Although there are features of the project that are unique to North Carolina, there are also elements that are transferable to any practice or state interested in integrating child development services into the medical home.

Study Design: QE: pretest-posttest

Setting: Partnership for Health Management, a network within Community Care of North Carolina

Population of Focus: Children ages 6 to 60 months receiving Early Periodic Screening, Diagnosis, and Treatment services

Data Source: Child medical record

Sample Size: Unknown number of charts – screening rates tracked in 2 counties (>20,000 screens by 2004)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Referrals,

Intervention Description: The intervention involves providing a self-screening tool and referral pathway pamphlet to expectant mothers and fathers. The intervention aims to assist new parents in detecting and seeking help for early symptoms of distress related to postnatal depression. The intervention described in the PDF file aligns with a discernable strategy of routine screening for distress or depressive symptoms in the perinatal period for both mothers and fathers. The authors suggest that the use of the Edinburgh Postnatal Depression Scale (EPDS) for screening of distress and depression in men needs to be linked to guidelines related to perinatal care, which currently focuses on the mothers.

Intervention Results: The gender differences in the EPDS, Kessler-10 and MSSS scales are represented by differences of 1.0 points on EPDS, 1.0 points on Kessler-10, fathers were reporting less psychological distress than mothers in all cases. No difference was observed in perceived social support. The attrition between time-points was mostly men. Cultural and socio-demographic factors may affect generalisability of the findings. The self-screening tool and referral pathway pamphlet provided to dyads may have some benefit in assisting couples in the perinatal period to detect and seek help for early symptoms of distress.

Conclusion: Cultural and socio-demographic factors may affect generalisability of the findings. The self-screening tool and referral pathway pamphlet provided to dyads may have some benefit in assisting couples in the perinatal period to detect and seek help for early symptoms of distress.

Study Design: The study design/type is a longitudinal intervention study. It involved collecting data at baseline (antenatally) and at 12 months postnatally to evaluate the effectiveness of a self-screening and referral pathway pamphlet given to dyads of expectant mothers and fathers. The study aimed to assess the primary hypothesis that scores on the depression scales are different in those dyads who received the intervention. The data collection involved a large private hospital in Melbourne, Australia, and the participants were followed up at 12 months by a researcher who was blinded to the dyad allocation. Ethical approval was received, and informed consent was obtained from all participants before data collection. The study design also included multivariate analyses, univariate analyses, repeated measures doubly multivariate analysis of variance, and multivariate analysis of covariance to investigate the effectiveness of the intervention

Setting: The study was conducted at a large private hospital in Melbourne, Australia, which has up to 2400 deliveries per year. Data collection took place between April 2014 and February 2015, and participants were followed up at 12 months by a researcher who was blinded to the dyad allocation. All follow-up data was collected by March 2016. The hospital setting provided the opportunity to recruit expectant mothers and fathers from a diverse demographic background, allowing for a broad representation of the target population.

Population of Focus: The target audience for the study appears to be expectant mothers and fathers, as the research aimed to evaluate the effectiveness of a self-screening and referral pathway pamphlet given to dyads of expectant mothers and fathers. The study collected data at a large private hospital in Melbourne, Australia, and the participants were followed up at 12 months postnatally. The demographic variables recorded at baseline included age range, marital status, number of children, country of origin, living arrangements, highest level of education, employment status, level of support, and whether or not the participant had been previously diagnosed with a mood disorder. Therefore, the target audience for the study was expectant mothers and fathers in the perinatal period.

Sample Size: The sample size of the study was 140 participants, comprising 70 dyads (35 dyads in the control and 35 dyads in the intervention). High attrition occurred with 43.5% of participants (mostly males) lost to follow-up at 12 months. There were 56.5% of the participants who provided usable data at baseline remaining in the study by 12 months. The sample is further summarized descriptively across treatment groups in Table 3 for the 78 participants who provided valid data at follow-up. This comprised of 30 dyads (60 individuals), plus 18 individuals (17 females and 1 male) who completed the follow-up questionnaires without their partner.

Age Range: The age range of the participants in the study was not explicitly mentioned in the provided excerpts. However, the study did include demographic variables such as age range, marital status, number of children, country of origin, living arrangements, highest level of education, employment status, level of support, and whether or not the participant had been previously diagnosed with a mood disorder. The age range of the participants was likely captured within the demographic data collected at baseline.

Intervention Components (click on component to see a list of all articles that use that intervention): Social Supports, Screening Tool Implementation, Family-Based Interventions,

Intervention Description: We assessed a cross-sectional sample of dyadic parent–child patients and young adult patients up to age 21 from one pediatric SCD center. Food insecurity, housing instability, and dietary quality were measured using validated US instruments and a food frequency questionnaire. Better dietary quality was defined using US dietary guidelines. Multivariate regression assessed for associations among dietary quality and food insecurity with or without (±) housing instability and housing instability alone.

Intervention Results: 70% reported less than or equal to one economic instability: 40% housing instability alone and 30% both food insecurity and housing instability. Eighty percent received more than or equal to one federal food assistance benefit. Compared to no economic instability, food insecurity ± housing instability was significantly associated with higher intake of higher dairy and pizza, while housing instability alone was significantly associated with higher dairy intake. Food insecurity ± housing instability was significantly associated with lower intake of whole grains compared to housing instability alone.

Conclusion: Our sample reported high frequencies of both food insecurity and housing instability; having more than or equal to one SDoH was associated with elements of poorer diet quality. Screening families of children with SCD for food insecurity and housing instability may identify those with potential nutrition-related social needs.

Study Design: cross-sectional

Sample Size: n=100

Age Range: mean age 10.6 ±

Intervention Components (click on component to see a list of all articles that use that intervention): Training, Collaboration with Local Agencies (State), Screening Tool Implementation,

Intervention Description: The intervention described in the article is the implementation of the EPDS screening tool during initial WIC consultations for women <12 months from delivery and providing resources for treatment options when a woman had a positive score. The article does not describe a specific strategy for implementing this intervention, but it does mention that the project involved training staff on PPD and the use of the EPDS, implementing the screening tool in the WIC clinic, and analyzing the collected data. Based on this information, it can be inferred that the strategy for implementing the intervention was a quality improvement approach that involved staff training, process changes, and data analysis to monitor and improve the screening process.

Intervention Results: Implementing PPD screening using the EPDS during initial WIC consultations for women <12 months from delivery was beneficial for this high-risk population, as it identified a higher percentage of positive scores for PPD than the national average. The study also found that providing resources for treatment options when a woman had a positive score was important for increasing the chances that they will receive treatment. Therefore, it can be inferred that increasing postpartum depression screening through the WIC program can be an effective strategy for identifying and treating PPD in this high-risk population.

Conclusion: It would be beneficial for the WIC program to screen women for PPD symptoms in this high-risk population, so that recommendations for follow-up care could be made and quality of life could be increased.

Study Design: The study design/type is not explicitly mentioned in the given texts. However, the study is described as a project that was approved by the New Mexico State University institutional review board, and it involved training staff on PPD and the use of the EPDS, implementing the screening tool in the WIC clinic, and analyzing the collected data. Based on this information, it can be inferred that the study design is a quality improvement project or a program evaluation.

Setting: The study was conducted in a Women, Infants, and Children (WIC) clinic in New Mexico.

Population of Focus: The target audience for the study is registered nurses and advance practice registered nurses.

Sample Size: The sample size is 72 women who were offered the EPDS screening tool.

Age Range: The WIC participants mentioned in the text include low-income women who are pregnant or postpartum and children up to age 5 years.

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Expert Support (Provider), Modified Billing Practices, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Expert Feedback Using the Plan-Do-Study-Act-Tool, Engagement with Payers, STATE, POPULATION-BASED SYSTEMS, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation (Provider)

Intervention Description: This report evaluates the impact of Phase II of Maine's First STEPS initiative

Intervention Results: Average percentage of documented use of a developmental screening tool increased substantially from baseline to followup for all three age groups (46% to 97% for children under one; 22% to 71% for children 18-23 months; and 22% to 58% for children 24-35 months). Rate of developmental screening based on MaineCare claims increased from the year prior to intervention implementation to the year after implementation for all three age groups (5.3% to 17.1% for children age one; 1.5% to 13.3% for children age two; and 1.2% to 3.3% for children age 3).

Conclusion: The authors summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement.

Study Design: QE: pretest-posttest

Setting: Pediatric and family practices serving children with MaineCoverage

Population of Focus: Children ages 6 to 35 months

Data Source: Child medical record; MaineCare paid claims

Sample Size: Unknown number of chart reviews from 9 practice sites completing follow-up

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention described in the article is the Screen-Refer-Treat (SRT) model, which is designed to promote an integrated and coordinated approach for early detection and specialized intervention for toddlers suspected of having Autism Spectrum Disorder (ASD). The SRT model comprises three components: 1. Screen: Primary care providers (PCPs) screen children at 18-month well-child checks using the Modified Checklist for Autism in Toddlers-Revised, with Follow Up (M-CHAT-R/F), a well-validated Stage 1 parent-report screening tool for detecting ASD in population-based settings. 2. Refer: PCPs immediately refer toddlers who screen positive to a community-based early intervention (EI) program. 3. Treat: Early intervention (EI) providers initiate ASD treatment after verifying ASD risk with a Stage 2 screen. The SRT model aims to use a preventive intervention approach and mitigate emerging ASD behaviors during a critical period of development. It involves a significant shift in the conceptualization and implementation of ASD services by offering an ASD-specialized intervention to toddlers when ASD is first suspected, rather than waiting until a formal ASD diagnosis is conferred. The model also involves two integral and interrelated parts of the service delivery system—primary care and early intervention—to increase care coordination and address obstacles associated with early detection and intervention through the use of technology to expedite screening.

Intervention Results: The article does not provide a summary of the results of the study, as it is focused on describing the study design, implementation, and challenges encountered during the research process. The article discusses the need for an earlier and more continuous route to specialized services for families of toddlers with ASD or suspected ASD, and the development of the SRT model to meet that need. The article also highlights the importance of addressing implementation barriers, such as provider hesitancy to discuss ASD concerns and challenges in modifying workflow, to improve the success of preventive intervention studies.

Conclusion: The article does not explicitly mention statistically significant findings. However, it does discuss the challenges encountered during the study, such as lower than projected recruitment numbers for the ASD Concerns group, and obstacles to the completion of provider and parent surveys,[object Object],. Additionally, the study discusses the adaptations made to increase recruitment for the ASD Concerns group and the strategies developed to address obstacles in data collection,[object Object],. These discussions suggest that the study faced challenges in achieving its planned sample sizes and data collection goals.

Study Design: The study design used in this research is a stepped-wedge cluster randomized controlled design. This is a type of pragmatic trial framework that allows for the sequential implementation of an intervention in different clusters or groups over time. In this study, the Screen-Refer-Treat (SRT) model was implemented sequentially in four underserved counties in Washington State, USA. The study also used a between-subjects approach to examine parent experiences, comparing a sample of parents recruited prior to SRT intervention to a separate sample of parents recruited after SRT intervention. The study used Generalized Linear Mixed Models (GLMMs) as the primary data analytic strategy to address the study research aims.

Setting: The study was conducted in four diverse counties in Washington State, USA. The Screen-Refer-Treat (SRT) model was implemented sequentially in these counties using a stepped-wedge cluster randomized controlled design. The research hub was centralized at the University of Washington, where IRB approval was obtained prior to the commencement of study activities and for all protocol amendments.

Population of Focus: The target audience for the study is likely researchers, healthcare providers, and policymakers interested in improving early detection and treatment for toddlers with Autism Spectrum Disorder (ASD) in underserved communities. The study protocol outlines a novel healthcare delivery model called Screen-Refer-Treat (SRT), which aims to increase community capacity for ASD detection and treatment before age 3. The study also discusses the successes, challenges, and adaptations made during the early implementation phase, which may be of interest to implementation researchers in ASD and those in other fields.

Sample Size: The sample size for the study is described in different parts of the article. For the ASD Concerns group, the planned sample size was 70 families total (35 Pre-SRT and 35 Post-SRT). For child outcomes, the planned sample size would allow the detection of small to moderate differences between the Pre- and Post-SRT cohorts at 80% power. For example, for child social communication, the sample size would allow the detection of a minimum increase of 40% more for the Post-SRT cohort relative to the Pre-SRT cohort assuming a similar amount of variation for both groups. For provider outcomes, based on inclusion of an estimated 40 primary care providers, the study would have sufficient sample size to detect approximately 22% point differences between Pre- and Post-SRT intervention reports at 80% power, assuming that 50% of primary care providers are implementing universal screening. With a sample of 80 early intervention providers, the study would have sufficient sample size to detect minimum 15% point differences between Pre- and Post-SRT intervention reports at 80% power.

Age Range: The age group targeted in the study is toddlers, specifically those under the age of 3. The intervention aims to increase community capacity for ASD detection and treatment before the age of 3, when it is likely to have the greatest impact. Additionally, the recruitment of families includes toddlers aged 16-35 months.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Policy/Guideline (Hospital), Assessment (patient/consumer), Screening in Nontraditional Settings

Intervention Description: The intervention described by the article to increase postpartum depression (PPD) screening is the implementation of a PPD screening program in a Pediatric Emergency Department (PED) setting . The study found that PED-based screening had a positive impact through PPD screening, education, and resources, and helped to identify PPD in mothers who had not been screened previously.

Intervention Results: The results found that 27% of mothers (n=209) screened positive for PPD, with 7% reporting suicidal thoughts . Additionally, 47% of mothers had never previously been screened for PPD, including 58% of PPD screen-positive mothers . The study also assessed maternal attitudes toward screening and found that PED-based screening had a positive impact through PPD screening, education, and resources, and helped to identify PPD in mothers who had not been screened previously

Conclusion: Approximately 1 in 4 mothers screened positive for PPD in a PED, with almost 1 in 10 reporting suicidal thoughts. The majority of PPD screen–positive mothers had not been screened previously. Our study helps to inform future efforts for interventions to support mothers of young infants who use the PED for care.

Study Design: To answer your question, the study design/type is a pilot cohort study of a convenience sample of mothers of infant patients

Setting: The study was conducted in a Pediatric Emergency Department (PED)

Population of Focus: The target audience for the study is healthcare providers, particularly those who work in pediatric emergency departments and are involved in the care of mothers and infants

Sample Size: The sample size for the study was 209 mothers of infant patients who presented to a PED from June 2015 to January 2016

Age Range: The study included mothers of infant patients 6 months or younger presenting to a Pediatric Emergency Department

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Training, Quality Improvement,

Intervention Description: The intervention described in the article is an evidence-based PPD screening guide implemented in a federally qualified health care facility (FQHC) to assess feasibility/sustainability and address the gap in practice. The screening was done using the Edinburgh Postpartum Depression Scale (EPDS) during the first to 6-month infant well checkups. Compliance with screening and feasibility of the referral protocol were assessed.

Intervention Results: During the trial period, 34 patients were seen between 27 days and 11 months of age, with 97% of mothers being scored on the EPDS. Of these, one mother of a 6-month-old Caucasian scored 13, and with her permission, a social worker . Compliance with screening and feasibility of the referral protocol were assessed. Mothers of patients aged 0 to 12 months in the study period were offered PPD screening 97% of the time. Providers and certified medical assistants agreed screening is important and generated a small increase in visit time. Screen scores identified one positive screen

Conclusion: PPD demands screening during the first year of the mother/infant relationship. Pediatric providers have the ideal scheduling of well visits in which to incorporate PPD screening. A barrier for some pediatric practices may be time to follow up after referring a mother to mental health for evaluation of compliance with outside appointments. Having mental health services as a part of the FQHC team allows immediate evaluation/treatment resources when needed.

Study Design: The study design/type is a blinded descriptive quantitative analysis using an implementation research design

Setting: The study was conducted at a FQHC (Federally Qualified Health Center)

Population of Focus: The target audience for the study is pediatric providers

Sample Size: During the trial period, 34 patients were seen between 27 days and 11 months of age

Age Range: The age group is between 27 days and 11 months of age

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Participation Incentives, Quality Improvement/Practice-Wide Intervention, Data Collection Training for Staff, Screening Tool Implementation Training, Audit/Attestation, HEALTH_CARE_PROVIDER_PRACTICE, Audit/Attestation (Provider)

Intervention Description: To assess the degree to which a national sample of pediatric practices could implement American Academy of Pediatrics (AAP) recommendations for developmental screening and referrals, and to identify factors that contributed to the successes and shortcomings of these efforts.

Intervention Results: At the project's conclusion, practices reported screening more than 85% of patients presenting at recommended screening ages. They achieved this by dividing responsibilities among staff and actively monitoring implementation. Despite these efforts, many practices struggled during busy periods and times of staff turnover. Most practices were unable or unwilling to adhere to 3 specific AAP recommendations: to implement a 30-month visit; to administer a screen after surveillance suggested concern; and to submit simultaneous referrals both to medical subspecialists and local early-intervention programs. Overall, practices reported referring only 61% of children with failed screens. Many practices also struggled to track their referrals. Those that did found that many families did not follow through with recommended referrals.

Conclusion: A diverse sample of practices successfully implemented developmental screening as recommended by the AAP. Practices were less successful in placing referrals and tracking those referrals. More attention needs to be paid to the referral process, and many practices may require separate implementation systems for screening and referrals.

Study Design: QE: interrupted timeseries design

Setting: Sixteen pediatric primary care practices from 15 different states

Population of Focus: Children ages 8 to 36 months at wellchild visits

Data Source: Child medical record

Sample Size: Chart audits: - Baseline and Follow-Up: (n=30) per practice in July 2006 and March 2007; total charts audited (n= 960) - Intervention period: (n=10) per practice per month for 7 months; total charts audited (n=1,120)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention involved the implementation of an evidence-based screening tool during routine sickle cell disease clinic appointments to prompt referral to multidisciplinary pain management services. The screening tool comprised eight items that included variables known to be associated with frequent, severe painful episodes. The screening information was authenticated verbally with the SCD patient or caregiver. The face validity of the tool was established via agreement solicited from stakeholders and population experts. The final decision to place a referral was agreed upon after a process of collaborative decision-making using a patient-centered approach among the patient, family, and sickle cell team. The process steps for placing multidisciplinary pain clinic referral were outlined and reviewed.

Intervention Results: Eighty-four percent of all eligible patients were screened during their routine sickle cell appointments resulting in a 110% increase in multidisciplinary pain management referrals. Future interventions and PDSA cycles are targeted at improving attendance at scheduled appointments, reducing hospitalizations, decreasing 30-day readmissions, and shortening length of stay.

Conclusion: The provided information does not explicitly mention statistically significant findings. The study primarily focuses on the implementation of a screening tool and the outcomes related to the number of patients referred to the multidisciplinary pain clinic. For detailed statistical significance, further information from the study or additional analysis would be required.

Study Design: The study utilized an evidence-based screening tool implemented at a pediatric academic medical facility serving as a regional sickle cell treatment center in the Midwest. The study design involved the implementation of a brief, eight-item screening tool during routine sickle cell disease clinic appointments to prompt referral to multidisciplinary pain management services. The study employed a quality improvement initiative to increase multidisciplinary pain management referrals for youth with sickle cell disease, indicating a quality improvement or implementation science approach to address the identified gap in practice.

Setting: The study was conducted at one pediatric academic medical facility serving as a regional sickle cell treatment center in the Midwest. This facility integrates comprehensive clinical services, research, and medical education to provide care for approximately 300 children and young adults with various types of sickle cell disease.

Population of Focus: The target audience for the study includes healthcare professionals, researchers, and practitioners involved in the care of children and adolescents with sickle cell disease. This may encompass pediatricians, hematologists, pain management specialists, psychologists, social workers, and other healthcare providers working in pediatric, academic medical facilities or regional sickle cell treatment centers. Additionally, the study findings may be of interest to professionals involved in pain management, quality improvement, and implementation research within the context of pediatric healthcare.

Sample Size: The study collected data during routine sickle cell appointments for 111 youth ages 2-20 years (M ¼ 11.75, SD¼5.34) from March 1 through August 31, 2018.

Age Range: The study included children greater than 2 years of age and less than 21 years of age with laboratory confirmed sickle cell disease.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, Educational Material,

Intervention Description: The intervention used in the study was a screening, brief intervention, referral, and treatment/follow-up (SBIRT) model, which was used to screen eligible patients, provide treatment options, and appropriately refer for follow-up to mental health services. The study analyzed a multicomponent intervention that included PMAD screening, maternal engagement/brief intervention, referral to mental health services, and clinic follow-up to ensure mental health care uptake.

Intervention Results: The study concluded that the use of the SBIRT (screening, brief intervention, referral, and treatment/follow-up) model to implement a safety bundle may contribute to improved mental health outcomes for individuals receiving perinatal care in a private-practice outpatient health care setting. The authors emphasized that education and engagement among clinicians, staff, and patients are key to the successful implementation of a safety bundle for perinatal mental health care. The study also highlighted the importance of maternal engagement, brief intervention, shared decision-making, and closed-loop referral processes in improving help-seeking behaviors and providing evidence-based care for perinatal mood and anxiety disorders (PMAD)

Conclusion: Use of the SBIRT model to implement a safety bundle may contribute to improved mental health outcomes for individuals receiving perinatal care in a private-practice outpatient health care setting. Education and engagement among clinicians, staff, and patients are key to successful implementation of a safety bundle.

Study Design: The study design was a rapid-cycle quality improvement model using four plan-do-study-act (PDSA) cycles over the course of 90 days. The study aimed to improve screening and care for perinatal mood and anxiety disorders (PMAD) in a private-practice women's health clinic. The interventions included screening with a validated tool, brief intervention, referral, and treatment/follow-up (SBIRT) model, and team engagement via weekly meetings. The study used measurements such as pre-post maternal and team engagement survey results, biweekly chart review, and run chart analysis to evaluate the effectiveness of the interventions

Setting: The study was conducted in a suburban, private-practice women's health clinic. The setting involved health care providers, staff, and eligible patients at a private-practice women's health clinic. The study aimed to address the local problem of low rates of PMAD screening and standardized PMAD care practices among health care providers in this specific setting

Population of Focus: The target audience for the study included health care providers (n=2), staff (n=4), and eligible patients (n=78) at a private-practice women's health clinic. The initiative aimed to improve screening and care for perinatal mood and anxiety disorders (PMAD) in this specific setting, making the health care providers, staff, and eligible patients the primary target audience for the intervention

Sample Size: The sample size for the study was 78 eligible patients who were screened for perinatal mood and anxiety disorders (PMAD) using the Edinburgh Postnatal Depression Scale (EPDS)

Age Range: The age range of the study participants was not explicitly mentioned in the article. However, as the study focused on perinatal mood and anxiety disorders (PMAD), it can be inferred that the participants were women in the perinatal period, which includes pregnancy and the postpartum period. Therefore, the age range of the participants would likely be between 18 and 45 years old, which is the typical age range for women in the perinatal period

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Screening Tool Implementation,

Intervention Description: The specific intervention described in the study was the screening and education of new mothers about postpartum depression by hospital-based perinatal nurses prior to hospital discharge. The intervention aligns with a discernable strategy of promoting screening, teaching, and referral of women for postpartum depression by hospital-based perinatal nurses.

Intervention Results: The study found that the majority of new mothers found it acceptable to be screened for postpartum depression and educated about community resources by hospital-based perinatal nurses. However, many new mothers were not asked about depressive symptoms by community providers. There was no significant correlation between demographics and depression risk. The study also found that group affiliation (high vs. low risk for depression) only affected the odds of experiencing postpartum depression symptoms after discharge. Less than half of the women were asked about postpartum depression after discharge, with the largest number being asked by both an obstetrician and pediatrician. The study suggests that communication between inpatient and community caregivers should be improved so that new mothers can benefit from seamless depression assessment, evaluation, and treatment

Conclusion: New mothers viewed depression screening and receiving information on community resources as a positive part of their care. Communication between inpatient and community caregivers should be improved so that new mothers can benefit from seamless depression assessment, evaluation, and treatment.

Study Design: The study design was descriptive. The study described in the article is a descriptive study. The study design involved the collection and analysis of quantitative data to describe or summarize a phenomenon, specifically the acceptability of postpartum depression screening and education by hospital-based perinatal nurses, and the further screening for postpartum depression that women received by community providers in the first few weeks after birth

Setting: The study was conducted in an academic health sciences center. New mothers were recruited from the mother-baby unit of this center.

Population of Focus: The target audience for the study includes healthcare professionals, particularly hospital-based perinatal nurses, as well as researchers and policymakers interested in postpartum depression screening and education for new mothers. Additionally, the findings may be relevant to organizations involved in maternal and child health care.

Sample Size: The study included a total of 101 new mothers, with 75 identified as high risk for depression and 26 in the comparison group at low risk for depression.

Age Range: The age group of the participants included new mothers aged 18 years and above. The study did not specify an upper age limit for the participants.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Referrals, School-Based Health Centers,

Intervention Description: The ProfScreen intervention involved a two-stage screening process. In the first stage, students completed a self-report questionnaire on mental health problems and risk behaviors. In the second stage, students considered at-risk based on the screening were invited for a clinical interview with a mental health professional and, if necessary, referred for subsequent treatment.

Intervention Results: Of the total N = 12,395 SEYLE study participants, 3070 were randomised to the ProfScreen and 3257 to the control group. Of those, 4172 (65.9%) completed the 12 month follow-up, were not emergency cases, and had complete data. Among those complete cases, 2583 (61.9%) students were considered at-risk for mental problems or risk behaviour at baseline; comprising 1314 (50.9%) students of the ProfScreen and 1269 (49.1%) of the control group. 535 (40.7%) students of the ProfScreen group attended the clinical interview and 149 (27.9%) of these were referred to subsequent treatment (Fig. 1). Subsequent data analyses refer to the 2583 students that were at-risk for mental health problems or risk behaviour at baseline. Compared to the control group, students of the ProfScreen group screened more often positive for suicidal tendencies and problems in social relationships at baseline (Table 1). The effect sizes of these differences were small. Sex, age, and all other baseline screening parameters did not differ between the ProfScreen and control group (Table 1).Effects of the ProfScreen intervention Of the total 2583 students at-risk for mental health problems or risk behaviour, 93 (3.6%) engaged in professional treatment within one year after the baseline assessment; 53 (4.1%) of the ProfScreen and 40 (3.1%) of the control group. Most of these students engaged in professional one-to-one therapy, followed by medication (see Online Resource 3). Neither follow-up service use (Table 2, unadjusted models in Online Resource 4) nor follow-up at-risk state (Table 3, unadjusted models in Online Resource 5) differed significantly between the ProfScreen and the control group, revealing no overall effects of the ProfScreen intervention.Post-hoc investigations for complete ProfScreen participation Within the ProfScreen intervention group, 40.7% participants took part in the interview offered (stage two of the intervention), referred to as ‘ProfScreen completers’. Post-hoc analyses of possible differences between ProfScreen completers and non-completers revealed that ProfScreen completers were younger (t(2581) = 5.22, p < 0.001). Looking only at the n = 535 ProfScreen completers, 29 (5.4%) engaged in professional treatment. Compared to the control group, ProfScreen completers had higher odds of engaging in service use with a professional, within one year after the intervention (OR = 1.78) (Table 4, unadjusted models in Online Resource 4). Regarding follow-up at-risk state, there were no differences between ProfScreen completers and participants of the control group (Table 5, unadjusted models in Online Resource 5).

Conclusion: Assignment to the ProfScreen intervention as implemented within the school-based SEYLE study had no effect on professional service use nor at-risk state compared to participation in the control group. The two-stage ProfScreen intervention suffered from low participation rates in the second part, the interview for clinical evaluation by professionals. Complete participation was positively associated with follow-up service use for young people at-risk for mental problems and risk behaviours, but the intervention was only able to reach 41% of eligible students for full participation. Overall, the present study highlighted two major difficulties in school-based screenings: less than half of the sample accepted the invitation for a clinical interview, and subsequently, only few students engaged in professional treatment. Thus, prior to the implementation of large-scale school-based screening programs as a regular tool to address young people’s mental health, further evidence and improvement of interview attendance rates as well as particular interventions targeting barriers to professional help are necessary.

Study Design: The study was a randomized controlled trial (RCT).

Setting: The study was conducted in 11 European countries as part of the SEYLE project.

Population of Focus: The target audience includes adolescents in school settings who were at risk for mental health problems and risk behaviors.

Sample Size: The total sample size was 4,172 students.

Age Range: The students were aged 15 ± 0.9 years.

Intervention Components (click on component to see a list of all articles that use that intervention): Health_Care_Provider_Practice, Screening Tool Implementation Training, Provider Training/Education

Intervention Description: The ECHO Autism STAT model was designed to provide diagnostic training for PCPs. At the outset of the program, participants attended a 1.5 day training, which included an orientation to the program, an overview of autism symptoms, and specific interactive and hands-on training on administration and interpretation of the STAT. Following the in-person training, PCPs participated in bimonthly 90-min ECHO Autism STAT clinics for 12 months, during which additional training in diagnosis and management of autism was provided through didactics and case-based learning, with an emphasis on evidence-based care and best-practice guidelines for screening, diagnosis, and management.

Intervention Results: Results indicated improvements in PCP practice and self-efficacy, and feasibility of the model for enhancing local access to care.

Conclusion: By combining hands-on training in standardized techniques with ongoing virtual mentorship and practice, the program emphasized both timely diagnosis and appropriate referral for more comprehensive assessment when necessary.

Setting: Pediatric practice

Population of Focus: Primary care peditricians

Intervention Components (click on component to see a list of all articles that use that intervention): Education/Training (caregiver), Screening Tool Implementation, Consensus Guideline Implementation,

Intervention Description: The intervention in this study was the ECHO Autism STAT model, which aimed to provide diagnostic training for primary care providers (PCPs) in screening and diagnosing young children at highest risk for autism. The model included a hybrid approach, combining hands-on training in standardized screening and diagnostic tools with ongoing video-based coaching and mentorship. The program involved monthly videoconferencing sessions where PCPs presented de-identified cases for discussion among the expert team and all participants, received feedback and recommendations, and had access to resources and toolkits for autism and other developmental disorders. Additionally, the program included training on the use of autism-specific screening measures and a diagnostic algorithm for autism, as well as a tiered process for diagnostic evaluation to foster timely access to diagnosis for children with the most severe symptoms,,.

Intervention Results: Results indicated improvements in PCP practice and self-efficacy, and feasibility of the model for enhancing local access to care.

Conclusion: Yes, the study found statistically significant improvements in primary care providers' (PCPs) use of autism-specific screening measures, as well as their self-efficacy in caring for children with autism, from pre- to post-training. Additionally, all participants reported changes in their practice behavior, relationships with patients and families, and perceived positive impact on their communities. However, it is important to note that the study had a small sample size and lacked a control or comparison group.

Study Design: The study design is a pilot project that used the ECHO Autism STAT model to provide diagnostic training for primary care providers (PCPs) based on the Missouri Best Practice Guidelines for diagnosis of ASD. The study used pre- and post-training questionnaires to assess changes in practice behavior and self-efficacy, and de-identified case presentation forms were also examined.

Setting: The study was conducted in underserved areas in the state of Missouri, focusing on training community-based primary care providers (PCPs) to improve screening and diagnosis of young children at highest risk for autism.

Population of Focus: The target audience for the study includes primary care providers (PCPs) such as general pediatricians, family medicine physicians, nurse practitioners, and physician assistants, particularly those practicing in underserved regions of Missouri.

Sample Size: The study initially enrolled a total of 18 primary care providers (PCPs) from 6 distinct geographic regions of the state of Missouri.

Age Range: The age group targeted in the ECHO Autism STAT program is early childhood, specifically focusing on children between the ages of 1 and 60 months. This program aims to improve access to early autism diagnosis and intervention for children in this crucial developmental stage.

Intervention Components (click on component to see a list of all articles that use that intervention): Health_Care_Provider_Practice, Screening Tool Implementation Training, Provider Training/Education

Intervention Description: Each EAE Hub, including clinicians and staff, participated in an on-site multiday intensive training on ASD evaluation. Included in the didactic curriculum were education on developmental screening, structured developmental history and interviewing techniques (including the assessment of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5] ASD symptoms), medical and psychological differential diagnosis and common comorbid concerns, communication skills for delivery of diagnosis, and current evidence regarding ASD interventions.

Intervention Results: Our findings suggest that developing a tiered system of developmental screening and early ASD evaluation is feasible in a geographic region facing health care access problems. Through targeted delivery of education, outreach, and intensive practice-based training, large numbers of young children at risk for ASD can be identified, referred, and evaluated in the local primary care setting.

Conclusion: The EAE Hub model has potential for dissemination to other states facing similar neurodevelopmental health care system burdens. Implementation lessons learned and key system successes, challenges, and future directions are reviewed.

Setting: Intervention sites ranged from large health systems to private pediatric practices

Population of Focus: Clinicians and staff of pediatric practices

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement/Practice-Wide Intervention, Screening Tool Implementation,

Intervention Description: The interventions included staff and patient engagement, screening process changes, and referral and treatment process changes. These interventions were implemented using the Plan-Do-Study-Act (PDSA) method and rapid cycles of iterative change. The study analyzed a multicomponent intervention that aimed to increase equity in perinatal depression screening, shared decision making, and treatment for incarcerated women. The intervention described aligns with a discernable strategy of using a quality improvement approach to implement evidence-based practices in correctional settings.

Intervention Results: The results of the study on perinatal depression screening and treatment for incarcerated women in the Milwaukee County Jail are as follows: 1. Staff Engagement: By the end of the implementation, eight out of 10 providers were competent in screening and engaging women, indicating an improvement in staff engagement . 2. Patient Engagement: Of the 93 women offered screening, 9% refused care, down from the 22% refusal rate at baseline. For women who screened positive and worked with the shared decision-making tool, the refusal rate decreased to 14% . 3. Screening and Treatment: A total of 101 women were seen, 93 were offered screening, 76 were screened, 43 were positive, and 37 started treatment within the facility. This indicates successful implementation of the screening and treatment process . 4. Overall Outcome: The project exceeded its aim, with 91% of pregnant and postpartum women housed at the Milwaukee County Jail being screened and provided treatment options for perinatal depression. The study revealed perinatal depression rates for incarcerated women that are more than double the national average estimates . These results demonstrate the effectiveness of the multicomponent intervention in standardizing perinatal depression screening and treatment, as well as the successful engagement of both staff and patients in the process.

Conclusion: Rapid cycle QI was effective in standardizing PD screening and treatment. Replication of this project across correctional systems would help to bridge a gap of equitable care for incarcerated women.

Study Design: The study design utilized the Plan-Do-Study-Act (PDSA) method of quality improvement (QI) with four rapid cycles. This method involves iterative changes and continuous evaluation of the impact of interventions on outcomes. The study employed a time series design with baseline data obtained from two months preceding the implementation to track changes over time, looking for shifts and trends. Additionally, the study utilized run charts to evaluate the impact of interventions on outcomes. These approaches allowed for the assessment of the effectiveness of the interventions and the measurement of various outcomes throughout the implementation process.

Setting: The study on perinatal depression screening and treatment for incarcerated women was conducted in the Milwaukee County Jail and House of Corrections in Milwaukee, Wisconsin, United States. The study setting is a correctional facility that houses both male and female inmates, but the focus of the study was on pregnant and postpartum women who were incarcerated in the facility. The study aimed to improve the quality of care for this population by implementing perinatal depression screening, shared decision-making, and treatment within the facility

Population of Focus: The target audience of the study on perinatal depression screening and treatment for incarcerated women in the Milwaukee County Jail is healthcare providers and administrators working in correctional facilities, particularly those caring for pregnant and postpartum women who are incarcerated. The study aims to increase equity in care for this vulnerable population by implementing perinatal depression screening, shared decision-making, and treatment. The findings of the study may also be of interest to researchers, policymakers, and advocates working to improve the health and well-being of incarcerated women and their children.

Sample Size: The sample size for the study on perinatal depression screening and treatment for incarcerated women in the Milwaukee County Jail was a total of 101 women who were seen during the project. Out of these women, 93 were offered screening, and 76 were screened. Additionally, 43 women had positive screens, and 37 of them started treatment within the facility

Age Range: The provided document does not explicitly mention the specific age range of the women included in the study on perinatal depression screening and treatment in the Milwaukee County Jail. However, it focuses on pregnant and postpartum women who were incarcerated, indicating that the age range likely corresponds to the reproductive age group. Typically, this encompasses women between the ages of 15 to 49 years. For precise details on the age range of the participants, it would be necessary to refer to the original study or contact the authors for further information.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Policy/Guideline (Hospital),

Intervention Description: The intervention aligns with the strategy of collaborative care, which involves a team-based approach to mental health care that includes primary care providers, mental health specialists, and care coordinators. The COMPASS program included several components, such as routine depression screening using the Patient Health Questionnaire-9 (PHQ-9), a standardized protocol for managing positive screens, and ongoing support and education for obstetric clinicians. The study analyzed the impact of the COMPASS program on depression screening and treatment recommendations before and after its implementation, using a cohort study design. The researchers used propensity score weighting to adjust for potential confounders and assess the effectiveness of the intervention in a real-world setting. Overall, the study demonstrates the effectiveness of a multicomponent collaborative care intervention in improving depression screening and treatment recommendations for perinatal women.

Intervention Results: The study found that after the implementation of the COMPASS program, women who received obstetric care were significantly more likely to receive antenatal screening for depression (81% versus 33%) and were more likely to receive a treatment recommendation if they had a positive antenatal screen for depression (61% versus 44%). The odds of screening for postpartum depression also significantly increased after the implementation of COMPASS (94.9% versus 92.8%). When a care plan was developed in response to a positive depression screen, the type of care plan significantly differed by implementation cohort. After the implementation of the COMPASS program, combined psychotherapy and pharmacotherapy were more frequently recommended, compared with before implementation. The study also noted that the data available were limited to recommendations for treatment by the obstetric clinician, and it did not reflect whether treatment was initiated or continued. Nevertheless, the study's findings suggest that the implementation of a collaborative care program can improve depression screening and treatment recommendations for perinatal women.

Conclusion: Implementation of a perinatal collaborative care program was associated with improvements in perinatal depression screening and recommendations for treatment by obstetric clinicians.

Study Design: The study utilized a cohort study design to evaluate the impact of the COMPASS program on depression screening and treatment recommendations for perinatal women. The cohort study was conducted from January 2015 to January 2019 and included all women who received prenatal care in five obstetric clinics and delivered at a single quaternary care hospital in Chicago. The study compared the completion of depression screening and recommendations for treatment before and after the implementation of the COMPASS program. In addition to the cohort study design, the researchers used statistical methods, such as propensity score weighting, to adjust for potential confounders and assess the effectiveness of the intervention in a real-world setting. This design allowed the researchers to analyze the impact of the multicomponent intervention on obstetric clinician behaviors and perinatal mental health outcomes.

Setting: The study was conducted in five obstetric care offices affiliated with an urban academic medical center in Chicago. These practices serve approximately 3,500 women annually and are staffed by obstetrician-gynecologist specialists, maternal-fetal medicine subspecialists, and certified nurse midwives. The setting for the study was within these obstetric care offices and the associated quaternary care hospital in Chicago, where the COMPASS (Collaborative Care Model for Perinatal Depression Support Services) program was implemented in January 2017. This setting allowed for the evaluation of the impact of the perinatal collaborative care program on depression screening and treatment recommendations by obstetric clinicians in a real-world clinical environment.

Population of Focus: The target audience for the study "Increased Depression Screening and Treatment Recommendations After Implementation of a Perinatal Collaborative Care Program" includes healthcare professionals, researchers, and policymakers involved in perinatal care, obstetrics, and mental health. The findings of the study are relevant to those interested in improving perinatal mental health care delivery, particularly in the context of collaborative care programs for perinatal depression. Additionally, the study's focus on the impact of the COMPASS program on depression screening and treatment recommendations makes it pertinent to professionals and organizations seeking to enhance perinatal mental health services and interventions.

Sample Size: The study included a total of 7,028 women who met eligibility criteria and received prenatal care in five obstetric clinics and delivered at a single quaternary care hospital in Chicago during the study period from January 2015 to January 2019. Of these, 3,227 (46%) women received prenatal care before the implementation of the COMPASS program, while 3,801 (54%) women received prenatal care after the implementation of the program. The study reported on the sociodemographic and clinical characteristics of the participants, including maternal age, insurance, parity, maternal race, maternal ethnicity, use of tobacco, history of substance use, and any maternal chronic medical problem.

Age Range: The study did not specify a specific age range for the participants. However, the study included all women who received prenatal care in five obstetric clinics and delivered at a single quaternary care hospital in Chicago during the study period from January 2015 to January 2019. The study did report on the sociodemographic and clinical characteristics of the participants, including maternal age, estimated gestational age at first prenatal visit, insurance, parity, maternal race, maternal ethnicity, use of tobacco, history of substance use, and any maternal chronic medical problem.

Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (Hospital), Screening Tool Implementation,

Intervention Description: The intervention aligns with the strategy of implementing a universal screening policy for perinatal depression. The study did not analyze a multicomponent intervention, as the focus was solely on the implementation of the screening policy.

Intervention Results: The results of the study showed that the frequency of completion of depression screening at the first prenatal visit, in the third trimester, and at the postpartum visit increased significantly after the initiation of the policy. The improvement in postpartum depression screening completion persisted even after controlling for potential confounders. Additionally, women with a positive postpartum depression screen were more likely to have depression treatment recommended or provided by their obstetrician post-policy

Conclusion: Implementation of an institutional policy of universal perinatal depression screening was associated with improvements in perinatal depression screening with concomitant improvements in depression treatment recommendations for women with a positive postpartum depression screen.

Study Design: The study design used in this research was a retrospective cohort study

Setting: The study was conducted at a single academic medical center in Illinois, specifically at Northwestern University, where a partnership between the Departments of Obstetrics and Gynecology and Psychiatry and Behavioral Sciences was established to implement the universal perinatal depression screening program

Population of Focus: The target audience for this study is healthcare providers, specifically those who provide perinatal care to pregnant women. The study evaluates the effectiveness of a universal perinatal depression screening program and its impact on the frequency of screening and depression treatment for pregnant women

Sample Size: The study included 5,127 women who met the inclusion criteria for the analysis. Of these women, 1,122 were in the pre-policy epoch, and 4,005 were in the post-policy epoch

Age Range: The age range of the women included in the study was not explicitly stated. However, the study did report the mean age of the women in the pre-policy and post-policy cohorts, which were 31.7 years and 30.8 years, respectively

Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Data Collection Training for Staff

Intervention Description: To determine the impact of the Healthy Steps for Young Children Program on quality of early childhood health care and parenting practices.

Intervention Results: Percentage of children with developmental assessments was 83.1% for intervention and 41.4% for control group (OR=8.00; 95% CI=6.69, 9.56; P<.001)

Conclusion: Universal, practice-based interventions can enhance quality of care for families of young children and can improve selected parenting practices.

Study Design: RCT and QE: nonequivalent control group

Setting: Pediatric practices in 14 states (6 randomization sites: San Diego, CA; Iowa City, IA; Allentown, PA; Pittsburgh, PA; Florence, SC; Amarillo, TX. 9 QE sites: Birmingham, AL/Chapel Hill, NC; Grand Junction, CO/Montrose, CO; Chicago, IL; Kansas City, KS; Boston, MA; Detroit, MI; Kansas City, MO; New York, NY; Houston, TX/Richmond, TX)

Population of Focus: Children ages 0-36 months

Data Source: Child medical record

Sample Size: Randomization Sites: - Intervention (n=832) - Control (n=761) - Total (n=1593) Quasi-Experimental Sites: - Intervention (n=1189) - Control (n=955) - Total (n=2144) Total: - All families (n=3737) - Intervention: (n=2021) - Control (n=1716)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The specific intervention described in the paper is the implementation of a standardized screening protocol for parental mental health symptoms in the Neonatal Intensive Care Unit (NICU). This intervention aligns with a discernible strategy of early identification and support for parents experiencing depression, anxiety, and PTSD symptoms in the NICU. The strategy aims to improve the well-being of NICU parents and ultimately enhance the parent-infant relationship. The study primarily focuses on the implementation and feasibility of the standardized screening protocol, as well as the effectiveness of the protocol in identifying parents in need of mental health referrals.

Intervention Results: The results of the study on implementing a standardized screening protocol for parental depression, anxiety, and PTSD symptoms in the Neonatal Intensive Care Unit (NICU) included the following key findings: 1. Feasibility and Acceptance: The standardized screening protocol was found to be feasible, widely accepted, and effective in establishing referrals for in-house mental health services . 2. Parental Mental Health Symptoms: Approximately 27% of parents had a positive screen that resulted in a mental health referral. Of those parents with positive screens, 40% endorsed psychiatric history, 20% reported previous trauma history, and 13% reported a history of substance abuse . 3. Impact on Referrals: Prior to developing the standardized screening program, the postdoctoral psychology fellow was receiving 1–2 referrals per week. Following implementation of the screening program, referrals then increased to about 4–5 per week . 4. Increased Identification of Symptomatic Parents: The screening program resulted in the increased identification of symptomatic parents and referrals for psychological support . These results indicate the effectiveness of the standardized screening protocol in identifying parental mental health symptoms and facilitating referrals for mental health support in the NICU.

Conclusion: Approximately 27% of parents had a positive screen that resulted in a mental health referral. The standardized screening protocol was found to be feasible, widely accepted, and effective in establishing referrals for in house mental health services. This model can be used as an example to help other NICUs implement their own universal screening protocols.

Study Design: The study design was a prospective observational study. The study aimed to describe the development and implementation of a standardized screening program for parents of infants in the Neonatal Intensive Care Unit (NICU) and to assess its implementation. The study collected data on parental mental health symptoms, including depression, anxiety, and trauma, using a standardized screening protocol. The screening began at 14 days post NICU admission and was implemented as part of routine medical care for all caregivers with infants admitted to the NICU at two weeks of age. The screenings were facilitated by pediatric social workers and psychology postdoctoral fellows and included a review of critical self-harm items. The study collected data on the feasibility, efficacy, and acceptability of the standardized screening protocol and determined a workflow for referring parents or caregivers to mental health services provided in the unit who screened positive for related symptoms. The study did not include a control group or randomization, and the data collected were observational in nature.

Setting: The study was conducted in the Neonatal Intensive Care Unit (NICU) of a tertiary care hospital in the United States

Population of Focus: The target audience for the study was parents or identified primary caregivers with infants hospitalized in the Neonatal Intensive Care Unit (NICU) for at least two weeks

Sample Size: The study included a total of 150 parents who had infants hospitalized in the NICU for at least two weeks and were eligible for screening. Of these, 129 (80%) were mothers and 30 (20%) were fathers

Age Range: The study included parents aged 18 to 42 years, with a mean age of 31.04 years

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Support/Counseling/Remediation, Referrals, Educational Material, YOUTH, PATIENT_CONSUMER, HEALTH_CARE_PROVIDER_PRACTICE, Screening Tool Implementation

Intervention Description: The obective of this study was to describe innovations added to the CEASE intervention and to track 2 year post-intervention implementation data on families who were screened for tobacco use.

Intervention Results: Electronic screening was used to routinely identify tobacco users, leading to increased potential for offering cessation assistance to all household members who smoke.

Conclusion: Improved delivery of smoking cessation services to families may be achieved by integrating technological innovations into routine pediatric practice.

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Health Centers, Screening Tool Implementation, Referrals,

Intervention Description: The Rhode Island Suicide Prevention Initiative (SPI) which links schools to mental health services through a coordinated screening, referral and follow-up system.

Intervention Results: Over 3 years, 328 students were referred by schools to mental health services, with 258 completing the referral (78.7% referral rate). Most parents consented to share info and participate in follow-up.

Conclusion: SPI links schools with mental health services to increase students receiving needed treatment. Evaluations of similar programs are limited. SPI reached multiple districts and age groups, with wrap-around follow-up services. This serves as a model for expanding school-based suicide screening and mental health referrals.

Study Design: Pre-post analysis of referral program data

Setting: Public schools in Rhode Island

Population of Focus: Students at risk for suicide, schools, mental health agencies

Sample Size: 328 students referred over 3 years

Age Range: 5-19 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Community Health Services Policy, Quality Improvement, Screening Tool Implementation,

Intervention Description: The intervention involved universal screening for postpartum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS) at multiple obstetric and pediatric practices in Houston, Texas. The EPDS is a 10-item self-report questionnaire that screens for symptoms of PPD. The intervention also included facilitating referrals for evaluation and treatment for women who screened positive for PPD. The study reports that the intervention was designed to increase access to perinatal mental health services. The intervention described in the study aligns with a discernable strategy of universal screening for PPD and facilitating referrals for evaluation and treatment. The study reports that the intervention was based on the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) guidelines for perinatal mental health.

Intervention Results: The study reports that a total of 102,906 screens for postpartum depression (PPD) were completed between May 2014 and July 2018. Of those, 6.3% screened positive for PPD. The obstetric practices completed 18,919 screens, and the pediatric practices completed 83,987 screens. The study also reports that 2,222 referrals were made, with 1,702 (76.6%) completed appointments. The remaining pediatric practices had 4,608 positive screens resulting in 1,390 (30.2%) referrals and 278 (20.0%) completed appointments. The study does not report on the women who received mental health care outside the TCH system.

Conclusion: This project demonstrated that with planning, systems review and trained staff, PPD screening can be integrated into obstetric and pediatric practices and high screening and referral rates can be achieved.

Study Design: The study design/type is a quality improvement project. The project was designed to increase access to perinatal mental health services through universal screening for postpartum depression (PPD) and facilitating referrals for evaluation and treatment, at a multi-site, integrated system of pediatric and obstetric practices in Houston, Texas. The study reports on the results of the project, including the number of screens completed, positive screens identified, referrals made, and appointments completed.

Setting: The study was conducted in an integrated multi-site pediatric and obstetric setting, which includes three hospitals and a Pavilion for Women (PFW) that provides inpatient and outpatient services in obstetric and gynecologic care. The Women’s Place—Center for Reproductive Psychiatry (The Women’s Place) is also located within the PFW and is dedicated to the treatment of women’s mental health

Population of Focus: The target audience for the study is healthcare providers, particularly those working in obstetric and pediatric practices, who are interested in implementing routine screening and referrals for perinatal mood disorders. The study provides a successful model for increasing access to perinatal mental health services in an integrated multi-site setting.

Sample Size: The sample size for the study is not explicitly stated in the given texts. However, the study reports that a total of 102,906 screens for postpartum depression were completed between May 2014 and July 2018, and 6487 (6.3%) of those screens were positive. The study also involved multiple obstetric and pediatric practices in Houston, Texas.

Age Range: The age group is not explicitly stated in the given texts. However, the study involved perinatal mental health services, which typically refers to the period during pregnancy and up to one year postpartum. The study also involved pediatric practices that screened women at the 2 week and 2, 4, and 6-month well-baby visit. Therefore, it can be inferred that the study focused on women who were pregnant or had recently given birth, as well as their infants.

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Motivational Interviewing, Screening Tool Implementation,

Intervention Description: Health risk behaviors are the most common sources of morbidity among adolescents. Adolescent health guidelines (Guidelines for Preventive Services by the AMA and Bright Futures by the Maternal Child Health Bureau) recommend screening and counseling, but the implementation is inconsistent. This study aims to test the efficacy of electronic risk behavior screening with integrated patient-facing feedback on the delivery of adolescent-reported clinician counseling and risk behaviors over time. This was a randomized controlled trial comparing an electronic tool to usual care in five pediatric clinics in the Pacific Northwest. A total of 300 participants aged 13-18 years who attended a well-care visit between September 30, 2016, and January 12, 2018, were included. Adolescents were randomized after consent by employing a 1:1 balanced age, sex, and clinic stratified schema with 150 adolescents in the intervention group and 150 in the control group. Intervention adolescents received electronic screening with integrated feedback, and the clinicians received a summary report of the results. Control adolescents received usual care. Outcomes, assessed via online survey methods, included adolescent-reported receipt of counseling during the visit (measured a day after the visit) and health risk behavior change (measured at 3 and 6 months after the visit).

Intervention Results: Of the original 300 participants, 94% (n=282), 94.3% (n=283), and 94.6% (n=284) completed follow-up surveys at 1 day, 3 months, and 6 months, respectively, with similar levels of attrition across study arms. The mean risk behavior score at baseline was 2.86 (SD 2.33) for intervention adolescents and 3.10 (SD 2.52) for control adolescents (score potential range 0-21). After adjusting for age, gender, and random effect of the clinic, intervention adolescents were 36% more likely to report having received counseling for endorsed risk behaviors than control adolescents (adjusted rate ratio 1.36, 95% CI 1.04 to 1.78) 1 day after the well-care visit. Both the intervention and control groups reported decreased risk behaviors at the 3- and 6-month follow-up assessments, with no significant group differences in risk behavior scores at either time point (3-month group difference: β=-.15, 95% CI -0.57 to -0.01, P=.05; 6-month group difference: β=-.12, 95% CI -0.29 to 0.52, P=.57).

Conclusion: Although electronic health screening with integrated feedback improves the delivery of counseling by clinicians, the impact on risk behaviors is modest and, in this study, not significantly different from usual care. More research is needed to identify effective strategies to reduce risk in the context of well-care.

Study Design: Randomized controlled trial

Setting: Five pediatric clinics in the Pacific Northwest

Population of Focus: Adolescents aged 13-18 years who attended a well-care visit at the pediatric clinics in Washington State

Sample Size: 300 adolescents (150 in intervention group and 150 in control group)

Age Range: Adolescents aged 13-18 years

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention involved the implementation of a mandatory electronic medical record (EMR) tool for SBIRT screening of all trauma and non-trauma adolescent inpatients. The SBIRT screening tool was incorporated into the electronic medical record (EPIC) and integrated into the admission workflow for admitting pediatric nurses. Upon patient admission to the pediatric unit, nurses completed the SBIRT screening questionnaire using the EMR tool. Patients who had a positive screen were identified by the nurse, who then notified the social worker and placed a social work consult. The intervention also included multidisciplinary training and coordination with social work and psychiatric consultants for brief intervention and referral to treatment for patients with positive screenings,.

Intervention Results: There were 873 patients before and 1,091 after implementation. Questionnaire screening increased from 0% to 34.4% (p < 0.001), without an increase in positivity rate, and lab screening decreased by 4.2% (p = 0.003). Females were more likely to receive a social work consultation than males (14.5 vs 7.5%, p < 0.001), despite a greater number of positive questionnaires among males (9.5 vs 17.9%, p = 0.013). White patients were more likely to receive a social work consultation (12.9%) compared to Asian (2%), Black (6.3%), and Other (6.9%) (p = 0.007), despite comparable rates of positive screenings. When comparing English to non-English speakers, English speakers were more likely to have a social work consult (12.0% vs 2.4%, p < 0.001) and psychiatry/psychology consult (13.6 vs 5.6%, p = 0.011).

Conclusion: Yes, the study reported several statistically significant findings. The implementation of an electronic medical record (EMR) tool and staff training increased SBIRT screening compliance from 0% to 34.4% (p < 0.001) among pediatric inpatients aged 12 to 18 years. The study also found that there was no increase in positivity rate, and lab screening decreased by 4.2% (p = 0.003) after the implementation of the EMR tool. However, the study identified demographic disparities in intervention rates, with females more likely to receive a social work consultation than males (14.5 vs 7.5%, p < 0.001), and white patients more likely to receive a social work consultation (12.9%) compared to Asian (2%), Black (6.3%), and Other (6.9%) (p = 0.007), despite comparable rates of positive screenings. The study also found that English-speaking patients were more likely to have a social work consult (12.0% vs 2.4%, p < 0.001) and psychiatry/psychology consult (13.6 vs 5.6%, p = 0.011) compared to non-English speaking patients,,.

Study Design: The study utilized a retrospective design to assess SBIRT compliance and disparities among pediatric inpatients at a tertiary care facility. The study population was divided into pre-implementation and post-implementation periods to evaluate the impact of the implementation of an electronic medical record (EMR) tool and staff training on SBIRT screening compliance. Additionally, subgroup analyses, such as the trauma subgroup analysis, were conducted to further explore the outcomes of interest. The study design involved the analysis of existing data to evaluate the effectiveness of the intervention and identify disparities in care,.

Setting: The study was conducted at a pediatric Level 1 trauma center associated with a tertiary care facility. The setting involved pediatric inpatient units at the facility, and the study assessed SBIRT compliance and disparities among adolescent inpatients, including those admitted to the trauma service,.

Population of Focus: The target audience for the study includes healthcare professionals, researchers, and policymakers involved in pediatric care, particularly those working in pediatric trauma centers and tertiary care facilities. Additionally, professionals interested in substance use screening, brief intervention, and referral to treatment (SBIRT) protocols for pediatric inpatients would also find this study relevant. The findings of the study may also be of interest to those focused on addressing healthcare-related disparities in pediatric populations,.

Sample Size: The study included a total of 1964 pediatric patients admitted to the facility between March 1, 2018, and January 15, 2021. Among these patients, those who met the following criteria were included in the study: (1) age 12 to 18 years, (2) no psychiatric diagnosis as the primary reason for admission. The study population was divided into pre-implementation (March 1, 2018, to February 28, 2019) and post-implementation (March 1, 2019, to January 15, 2021) periods. The sample size for the trauma subgroup analysis was 88 patients hospitalized for trauma, with 40 patients in the post-implementation period,.

Age Range: The study focused on pediatric inpatients aged 12 to 18 years old. This age group was included in the analysis to assess SBIRT compliance and disparities among adolescent patients at the tertiary care facility.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, EMR Reminder,

Intervention Description: The intervention aligns with the strategy of improving screening and referral rates for postpartum depression in the pediatric primary care setting. The article describes a quality improvement project that analyzes a multicomponent intervention, including education and preparation, EMR adaptations, and stakeholder engagement and collaboration.

Intervention Results: The results of the intervention showed a significant increase in the clinic's screening rate from 33% to 80% and an improvement in referral rates from 66% to 79% . These findings indicate that the implementation of the standardized screening schedule and referral algorithm had a positive impact on the clinic's ability to identify and refer mothers with symptoms of postpartum depression for further evaluation and care.

Conclusion: By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.

Study Design: The study design is a quality improvement (QI) project that standardized the postpartum depression (PPD) screening schedule and implemented a novel referral algorithm in a rural primary care pediatric practice The project aimed to assess the impact of these interventions on the clinic's screening and referral rates for postpartum depression. The study utilized a pre-post intervention design to evaluate the changes in screening and referral rates before and after the implementation of the standardized screening schedule and referral algorithm.

Setting: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . This setting reflects a real-world healthcare environment where the interventions and changes in practice were implemented and evaluated. The rural context of the pediatric practice is also an important consideration, as it may have implications for the generalizability of the study's findings to similar healthcare settings.

Population of Focus: The target audience for the study includes healthcare providers in pediatric primary care settings, particularly pediatricians, pediatric nurse practitioners, and pediatric nurses. The interventions and findings of the study are relevant to healthcare professionals involved in the care of infants, children, and adolescents, as well as their mothers. Additionally, the study's insights may also be of interest to professionals involved in maternal mental health, quality improvement initiatives, and those seeking to enhance postpartum depression screening and referral practices in pediatric primary care.

Sample Size: The specific sample size for the study is not explicitly mentioned in the provided excerpts. However, the study collected baseline data from 109 well visits during a 1-month time period before the project's implementation . This information provides insight into the scale of the initial data collection. For a more detailed understanding of the sample size and its implications for the study's findings, it may be necessary to refer to the complete article.

Age Range: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . Therefore, the age range of the patients included in the study spans from newborns up to 21 years old. This broad age range reflects the pediatric focus of the primary care practice and the potential impact of the interventions on a diverse patient population.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, EMR Reminder,

Intervention Description: The intervention aligns with the strategy of improving screening and referral rates for postpartum depression in the pediatric primary care setting. The article describes a quality improvement project that analyzes a multicomponent intervention, including education and preparation, EMR adaptations, and stakeholder engagement and collaboration.

Intervention Results: The results of the intervention showed a significant increase in the clinic's screening rate from 33% to 80% and an improvement in referral rates from 66% to 79% . These findings indicate that the implementation of the standardized screening schedule and referral algorithm had a positive impact on the clinic's ability to identify and refer mothers with symptoms of postpartum depression for further evaluation and care.

Conclusion: By standardizing PPD screening and implementing a referral algorithm in the ambulatory pediatric setting, more PPD cases can be identified, further evaluated, and, hopefully, treated to improve maternal and infant health outcomes.

Study Design: The study design is a quality improvement (QI) project that standardized the postpartum depression (PPD) screening schedule and implemented a novel referral algorithm in a rural primary care pediatric practice The project aimed to assess the impact of these interventions on the clinic's screening and referral rates for postpartum depression. The study utilized a pre-post intervention design to evaluate the changes in screening and referral rates before and after the implementation of the standardized screening schedule and referral algorithm.

Setting: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . This setting reflects a real-world healthcare environment where the interventions and changes in practice were implemented and evaluated. The rural context of the pediatric practice is also an important consideration, as it may have implications for the generalizability of the study's findings to similar healthcare settings.

Population of Focus: The target audience for the study includes healthcare providers in pediatric primary care settings, particularly pediatricians, pediatric nurse practitioners, and pediatric nurses. The interventions and findings of the study are relevant to healthcare professionals involved in the care of infants, children, and adolescents, as well as their mothers. Additionally, the study's insights may also be of interest to professionals involved in maternal mental health, quality improvement initiatives, and those seeking to enhance postpartum depression screening and referral practices in pediatric primary care.

Sample Size: The specific sample size for the study is not explicitly mentioned in the provided excerpts. However, the study collected baseline data from 109 well visits during a 1-month time period before the project's implementation . This information provides insight into the scale of the initial data collection. For a more detailed understanding of the sample size and its implications for the study's findings, it may be necessary to refer to the complete article.

Age Range: The study took place in a rural primary care pediatric practice that serves patients up to 21 years of age . Therefore, the age range of the patients included in the study spans from newborns up to 21 years old. This broad age range reflects the pediatric focus of the primary care practice and the potential impact of the interventions on a diverse patient population.

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment, Educational Material (Provider), Screening Tool Implementation Training

Intervention Description: Prevention programs serve those at high risk by removing external risk factors, providing enriching environments, training parents on responsiveness and positive redirection to build skills for optimal development. Remediation programs are for children diagnosed with developmental disturbances, attempting to maximize competence and minimize delays. Compensation services target established disorders like cerebral palsy or Down syndrome, aiming to maximize overall functioning through aids and behavioral techniques. This article states that intervention programs tend to have a positive moderate effect on developmental attainment, with structured, intense programs providing family support being more effective. Earlier intervention in infancy may lead to better outcomes, though evidence is unclear. Appropriate early intervention services can help optimize development for delayed children.

Intervention Results: The resource presents several key results related to intervention programs for children with developmental delays. It states that intervention programs have been shown to have a positive moderate effect on eventual developmental attainment, improving intellectual, academic achievement, and scores on developmental outcomes measures. Prevention services specifically have been found to have significant lasting effects into adulthood, with children who participated being less likely to fail grades, be assigned to special programs, have higher achievement scores, be more likely to graduate high school and seek higher education, and have higher earning wages as adults. The Ypsilanti Perry Preschool Project calculated savings to society of $100,000 per child who participated. For biologically at-risk populations, intervention facilitated short-term gains in growth, development, and improved parenting skills.

Conclusion: This resource concludes that while more methodologically sound longitudinal studies are needed, the available evidence suggests that early intervention programs can benefit children with or at risk of developmental delays. It proposes that for intervention to be effective, programs should be structured, intense, involve family support services, and begin as early as possible in a child's life. The passage endorses developmental screening as a crucial step to identify delayed children early so they can receive appropriate intervention services to maximize their developmental potential.

Study Design: N/A

Setting: N/A

Data Source: N/A

Sample Size: N/A

Age Range: N/A

Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Screening Tool Implementation Training

Intervention Description: The purpose of this study was to examine the feasibility and effectiveness of implementation of validated developmental screening by using the Parents' Evaluation of Developmental Status in 2 urban pediatric practices.

Intervention Results: Providers found routine screening easier than expected and feasible to conduct in a busy primary care setting. The practice change resulted in screening of 61.6% of eligible children. Compared with same-aged children before screening, after screening was implemented more behavioral concerns were detected in the 2-year-old group, and more children with developmental concerns were identified in the 3-year-old group. Referral rates for additional evaluation increased only for 3-year-olds, although the types of referrals (ie, audiology and early intervention) were consistent as those found before screening started.

Conclusion: Implementation of validated screening by using the Parents' Evaluation of Developmental Status was feasible in large, urban settings. Effectiveness was demonstrated via chart review documenting an increased rate of identification of developmental and behavioral concerns. Perceived obstacles, such as the time requirement, should not prevent widespread adoption of screening.

Study Design: QE: pretest-posttest

Setting: Boston Children’s Hospital Primary Care Center (CHPCC) and Joseph Smith Community Health Center in Massachusetts

Population of Focus: Children ages 2-3 years (20-40 months) receiving well-child visits

Data Source: Child medical record

Sample Size: Medical charts reviewed6 : - Baseline (n=338) o Children aged 2 years (n=169) o Children aged 3 years (n=169) - Follow-up (n=278) o Children aged 2 years (n=127) o Children aged 3 years (n=151) - Total charts (n=616)

Age Range: Not specified

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention in this study involved the integration of an online screening tool, the Smart Early Screening for Autism and Communication Disorders (ESAC), into standard practice for eligible well-child visits in a busy pediatric office in central Florida. The Smart ESAC is an autism-specific screening tool that can be administered via computer, tablet, or smartphone with automated scoring to simplify result sharing with parents and upload to an electronic health record (EHR). Once screened, parents are invited to an online portal through which subsequent screenings can be completed prior to future office visits. Parents can also access several resources and tools based on the outcome of their child’s screen. The study also included an online professional development course for medical providers and medical students to train them on the use of the Smart ESAC screening tool.

Intervention Results: The study observed several trends, including a 100% screening rate for 12- and 18-month visits by the final interval, marked improvement in screening rates for the 15-month visit, and a strong increase in integration for the 24- and 30-month screenings until the final time interval. Additionally, the study found that the Smart ESAC screening tool led to a statistically significant reduction in the average age of referral for a diagnostic evaluation for ASD, with an average age of referral dropping to 19.7 months after implementation. These results support the effectiveness of the Smart ESAC screening tool in improving the detection of early signs of autism and lowering the age of referral for evaluation.

Conclusion: Yes, the study found statistically significant results. The average age of referral for a diagnostic evaluation for ASD was reduced from 37.2 months to 19.7 months after the implementation of the Smart ESAC screening tool, with a large effect size. Results of an independent samples t-test indicated a statistically significant reduction in average age of referral, with a large effect size: t(51) = 5.51, P < .001; Cohen’s d = 1.71.

Study Design: The study is a quality improvement (QI) project.

Setting: The study was conducted in a busy pediatric office in central Florida.

Population of Focus: The target audience for the study includes primary care pediatricians, medical providers, and office staff involved in the screening and referral of young children for autism spectrum disorder (ASD).

Sample Size: The study reviewed a total of 391 well-child visits over the course of 1 year.

Age Range: The age group targeted in the study is 12 to 30 months.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention aligns with a discernable strategy of integrating postpartum depression screening into routine pediatric care, aiming to identify and support families that may benefit from early interventions.

Intervention Results: The study found that in the sample of 2203 couples who completed the assessment, 19.9% of mothers, 6.3% of fathers, and 5% of couples reported any depressive symptomatology. Specifically, 5.3% of mothers and 0.8% of fathers were classified as 'likely depressed' . The study also identified associations between maternal postnatal depressive symptoms and factors such as having a diagnosed psychiatric disorder during pregnancy, not exclusively breastfeeding at hospital discharge, and the presence of child sleeping disorders at 3 and 6 months. For fathers, a significant association was reported between likely depressed fathers and child sleeping disorders at 3 months, as well as with having a likely depressed partner . These findings suggest the importance of considering various factors in identifying and supporting parents with postnatal depressive symptoms

Conclusion: The findings of this study support the feasibility of an active screening programme for parental postnatal depression during well-child visits as an integral part of postpartum care.

Study Design: The study was conducted within the NASCITA (NAscere e creSCere in ITAlia) cohort, which is a prospective, population-based birth cohort study , . The data were collected by family paediatricians during well-child visits in Italy, where primary healthcare for children is provided exclusively by family paediatricians as part of the universalistic health system organization

Setting: The data for this study were collected within the NASCITA (NAscere e creSCere in ITAlia) cohort. The study was conducted in Italy, and the setting involved well-child visits conducted by family paediatricians as part of the universalistic health system organization in the country. The study utilized data from the well-child visits to assess the feasibility of identifying signs of postpartum depression in parents during these visits , .

Population of Focus: The target audience for this study includes healthcare professionals, researchers, and policymakers who are interested in perinatal mental health and the identification of postpartum depression in parents. The study aimed to evaluate the feasibility of using family paediatricians to identify signs of postpartum depression in parents during well-child visits, which could have implications for the early detection and management of perinatal mental health issues. The findings of the study may be relevant to healthcare professionals who provide care to parents and infants, as well as researchers and policymakers who are interested in improving perinatal mental health outcomes

Sample Size: The sample size for this study was 2650 mothers and 2231 fathers who had complete data for all the visits considered. The families were recruited from 129 family paediatricians in Italy, and the data were collected during the first 6 months of the infant's life. The study aimed to assess the feasibility of identifying signs of postpartum depression in parents during well-child visits, and the sample size was considered sufficient for this purpose

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Referrals, Teacher/Staff Training,

Intervention Description: Universal school-based depression screening compared to targeted screening based on concerning behaviors

Intervention Results: A total of 12 909 students were included (median age, 16 years [range, 13-21 years]; 6963 male [53.9%]), of whom 2687 (20.8%) were Hispanic, 2891 (22.4%) were non-Hispanic Black, 5842 (45.3%) were non-Hispanic White, and 1489 (11.5%) were multiracial or of other race or ethnicity. A total of 6473 students (50.1%) were randomized to universal screening, and 6436 (49.9%) were randomized to targeted screening. Adolescents in the universal screening group had 5.92 times higher odds (95% CI, 5.07-6.93) of being identified with MDD symptoms, 3.30 times higher odds (95% CI, 2.49-4.38) of SAP confirming follow-up needs, and 2.07 times higher odds (95% CI, 1.39-3.10) of initiating MDD treatment. No differences were identified in initiation for planned subgroup analyses by sex or race and ethnicity.

Conclusion: In this randomized clinical trial, universal school-based MDD screening successfully increased identification of MDD symptoms and treatment initiation among adolescents, confirming the value of this approach to address this rising public health concern.

Study Design: Randomized clinical trial

Setting: Public high schools in Pennsylvania, US

Population of Focus: High school students grades 9-12

Sample Size: 12909

Age Range: 13-21 years

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation,

Intervention Description: The intervention in this study involved the implementation of a multi-stage screening process designed to detect and diagnose autism spectrum disorder (ASD) in children aged 0-3 years who were receiving early intervention (EI) services. The screening process was incorporated into the routine clinical practice of three EI agencies that primarily serve low-resource families in an urban area of the USA. The study team provided training and support to EI providers to implement this screening process. Participating families whose children screened positive at both screening stages 1 and 2 were offered a free diagnostic evaluation conducted by clinical psychologists on the research team. The multi-stage screening process aimed to identify children at risk for ASD and facilitate their timely referral for diagnostic evaluation and early intervention services.

Intervention Results: Referrals based on concern alone were cost-effective in the current study, and reported concerns were stronger predictors than positive screens of time-to-complete referrals. Qualitative analyses suggest a dynamic relationship between parents' concerns, providers' concerns, and screening results that is central to facilitating shared decision-making and influencing diagnostic assessment.

Conclusion: Yes, the study reported statistically significant findings related to the effectiveness of the multi-stage screening process and the influence of parental and provider concerns on the completion of stage 2 screening. Specifically, the study found strong associations between screening scores, provider concerns, perception of parent concerns, and the likelihood of completing stage 2 screening. Additionally, the study evaluated the cost-effectiveness of different referral pathways and hypothesized that Path A (positive screen + concern) would be most efficient, yielding the lowest cost per ASD diagnosis. These findings contribute to the understanding of the factors that drive the detection and diagnosis of autism spectrum disorder in early intervention settings.

Study Design: The study utilized a convergent, mixed methods design with concurrent quantitative and qualitative components. This approach allowed the researchers to gather both quantitative data on the effectiveness of the screening process and qualitative data on the perspectives of early intervention providers and parents involved in the multi-stage screening protocol.

Setting: The study was conducted in early intervention (EI) settings, where the research team provided ongoing training to EI providers in the use of evidence-based screening instruments for signs and symptoms of autism spectrum disorder (ASD). The EI providers were involved in administering the screening instruments and engaging in shared decision-making with the parents throughout the multi-stage screening protocol.

Population of Focus: The target audience for this study is likely professionals and researchers in the field of early intervention and autism spectrum disorder (ASD), as well as policymakers and stakeholders interested in improving the screening and diagnostic process for young children at risk for ASD. The study provides insights into the effectiveness of a multi-stage screening process and the importance of shared decision-making between parents and early intervention providers.

Sample Size: The study included a total of 1,654 children who completed stage 1 screening for autism spectrum disorder (ASD). This sample size reflects the diverse population of children who were referred to early intervention services and underwent the multi-stage screening process as part of the study.

Age Range: The age group in this study is young children who completed stage 1 screening, with an average age of 23.8 months (SD = 5.4), and an average age of ASD diagnosis of 27.4 months (SD = 4.9).

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Social Supports, Referrals, Screening Tool Implementation Training

Intervention Description: The Iowa Department of Public Health’s 1st Five Healthy Mental Development Initiative is bridging public and private health care systems to improve early detection of social-emotional delays and prevention of mental health problems among young children and their families. Key features of the 1st Five model include: user-friendly mental and developmental health screening and referral forms; ongoing education and support for medical office staff on healthy development and use of screening and referral tools; specially trained care coordinators to identify and address a wide range of children’s and families’ needs; relationships with community resources that provide early intervention; and timely notification of outcomes to the referring physician offices.

Intervention Results: With an evaluation under way, early 1st Five experience indicates that families identified through the program have a range of unmet needs: each physician referral results in an average of three to five follow-up referrals for services.

Conclusion: The early experience in Iowa indicates that there are substantial opportunities to improve early detection of social–emotional delays and problems and prevention of mental health problems by strengthening the connection between physicians and the public health system and providing comprehensive care coordination. This requires building relationships and changing mindsets and practices at the community and clinic level. It requires modest funding and does not happen overnight. An ongoing evaluation of the 1st Five initiative will yield important evidence about the benefits and challenges of this approach. If early indications are borne out, adoption and replication in other communities and states may be warranted. The Iowa model itself is adapted from similar programs in North Carolina and Connecticut. The model can be a “win-win-win” situation. It can provide overburdened primary care physicians and their staff with the knowledge and tools to identify at-risk patients and make easy, fast referrals, with the assurance that they will be informed of the outcomes. It can also allow the public health system to better perform its surveillance and early intervention functions. Finally, it can provide critical treatment and relief to young children and their families, alleviating or avoiding exacerbation of early developmental problems and other family crises and enhancing the likelihood of a healthy, productive future.

Study Design: N/A

Setting: Iowa

Data Source: the Child and Family Policy Center,

Sample Size: N/A

Age Range: young children ages 0 to 5 years and their families,

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Screening Tool Implementation,

Intervention Description: The intervention in this study was the implementation of the Get SET Early Model, which stands for Screen, Evaluate, and Treat. The model involved training primary healthcare providers (PHPs) to administer the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (CSBS-ITC) at 12-, 18-, and 24-month well-baby visits and referring toddlers whose scores indicated the need for a developmental evaluation. Licensed psychologists were trained to provide diagnostic evaluations to toddlers as young as 12 months. The study also involved the creation of an Infant/Toddler Autism Evaluation Center, where a licensed psychologist performed evaluations. The lead psychologist established reliability with the lead psychologist at the San Diego Get SET site. The model aimed to reduce the mean age of ASD detection and treatment referral and facilitate treatment engagement for all toddlers with ASD by 36 months,,.

Intervention Results: In 4 years, 45,504 screens were administered at well-baby visits, and 648 children were evaluated at least 1 time. The overall median age for ASD diagnosis was 22 months, which is significantly lower than the median age reported by the CDC (57 months). For children screened at 12 months, the age of first diagnosis was significantly lower at 15 months. Of the 350 children who completed at least 1 follow-up evaluation, 323 were diagnosed with ASD or another delay, and 239 (74%) were enrolled in a treatment program.

Conclusion: Yes, the study reported statistically significant findings. The median age for ASD diagnosis was significantly lower at 22 months compared to the median age reported by the CDC (57 months). Additionally, the study demonstrated improved screening and referral behaviors among pediatric healthcare providers (PHPs) after implementing the Get SET Early Model, with notable increases in the use of a standardized screening tool and referral for evaluation. These findings indicate the effectiveness of the model in improving early detection and referral practices for toddlers with ASD.

Study Design: The study design is a program evaluation, specifically a pre-post design, which evaluated the effectiveness of the Get SET Early Model in improving screening, evaluation, and referral practices for toddlers with autism spectrum disorder (ASD) in a community-based center in Arizona. The study compared the age of diagnosis for toddlers with ASD before and after the implementation of the model,.

Setting: The study was implemented in a community-based center for autism treatment and research in a city in Arizona, which has consistently had one of the highest median ages of diagnosis for autism spectrum disorder (ASD) according to the Autism and Developmental Disorders Monitoring Network (ADDM),.

Population of Focus: The target audience for the study includes healthcare professionals, pediatricians, early intervention specialists, researchers, and policymakers involved in the early detection and intervention of autism spectrum disorder (ASD) in toddlers. Additionally, the findings of the study are relevant to organizations and communities aiming to improve early screening, evaluation, and referral practices for ASD in young children,.

Sample Size: The study involved a sample of 648 toddlers who were diagnosed within 7 weeks of screening, with a mean age of 40.3 days for the diagnostic process. Additionally, the study compared the data from the Get SET Early implementation to the Arizona site of the ADDM network 2014 surveillance year, which included 349 children.

Age Range: The age group in the context of the provided information refers to the age at which toddlers were screened for developmental delays, particularly for autism spectrum disorder (ASD). The screening ages mentioned in the document include 12 months, 18 months, and 24 months. These screening ages were used to assess the effectiveness of the Get SET Early Model in identifying developmental delays, including ASD, at an early age,,.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Quality Improvement, Expert Feedback Using the Plan-Do-Study-Act-Tool, Screening in Nontraditional Settings

Intervention Description: The intervention includes a standardized postpartum depression screening tool into pediatric primary care practice to increase postpartum depression screening rates.

Intervention Results: The study found that postpartum depression screening practices improved from 83% to 88% after the implementation of the standardized screening tool, although this improvement was not statistically significant . The study also found that certain infant and family characteristics, such as male gender, Medicaid or sliding-scale payment for services, and Hispanic ethnicity, were associated with higher rates of positive postpartum depression screens, although again, these associations were not statistically significant . Another study mentioned in the text found that the implementation of a standardized screening tool increased the rate of screening for postpartum depression from 83% to 100%

Conclusion: Pediatric health care providers can effectively screen for postpartum depression. Certain infant and family characteristics may alert the provider to higher risks for mothers.

Study Design: The study design/type is not explicitly mentioned in the given texts. However, the study is a quality improvement project that aimed to improve postpartum depression screening in a pediatric primary care clinic . The study used pre- and post-intervention data to compare the screening rates before and after the implementation of a standardized screening tool . Therefore, it can be classified as a quasi-experimental study.

Setting: The quality improvement project took place in a nurse-led, rural FQHC (Federally Qualified Health Center) in north-central Indiana that offers primary care services, including pediatrics, family health, women's health, and behavioral health

Population of Focus: The target audience for this study is pediatric health care providers who are interested in improving postpartum depression screening in their practice

Sample Size: The sample size for this study was 116 women

Age Range: The age group is not specified in the given texts. However, since the study is about postpartum depression screening, it can be inferred that the sample consists of women who have recently given birth

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation Training, HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education

Intervention Description: Forty-six PCPs from 10 diverse practices across four counties in Washington State participated. PCPs attended a 2-hour training workshop on early recognition and care for toddlers with ASD and use of a REDCap-based version of the Modified Checklist for Autism in Toddlers–Revised with Follow-up (webM-CHAT-R/F) that provided automated presentation and scoring of follow-up questions. Data were collected at baseline and 6 months following each county's training window. PCPs’ screening methods and rates and perceived self-efficacy regarding ASD care were measured by self-report and webM-CHAT-R/F use was measured via REDCap records.

Intervention Results: At follow-up, 8 of the 10 practices were using the webM-CHAT-R/F routinely at 18-month visits. The proportion of PCPs reporting routine M-CHAT screening increased from 82% at baseline to 98% at follow-up (16% increase, 95% confidence interval [CI] 3%-28%; McNemar exact P = .02). The proportion using the M-CHAT-R/F follow-up interview questions increased from 33% to 82% (49% increase, 95% CI 30%-68%, exact McNemar test, P < .001). Significant increases in self-efficacy were found for all seven areas assessed (Ps ≤ .008).

Conclusion: This brief intervention increased PCPs' self-reported valid use of the M-CHAT-R/F at 18 months and their self-efficacy regarding ASD care. Combining educational information with a web-based ASD screen incorporating the M-CHAT-R/F follow-up questions may increase universal ASD screening with improved fidelity.

Setting: Clinical practice

Population of Focus: Primary care peditricians

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Educational Material (Provider), HEALTH_CARE_PROVIDER_PRACTICE, Screening Tool Implementation

Intervention Description: To determine whether an intervention addressing both logistical and knowledge barriers to early screening for autism spectrum disorder (ASD) increases evidence-based screening during 18-month well-child visits and primary care providers' (PCPs') perceived self-efficacy in caring for children with ASD.

Intervention Results: At follow-up, 8 of the 10 practices were using the webM-CHAT-R/F routinely at 18-month visits. The proportion of PCPs reporting routine M-CHAT screening increased from 82% at baseline to 98% at follow-up (16% increase, 95% confidence interval [CI] 3%-28%; McNemar exact P = .02). The proportion using the M-CHAT-R/F follow-up interview questions increased from 33% to 82% (49% increase, 95% CI 30%-68%, exact McNemar test, P < .001). Significant increases in self-efficacy were found for all seven areas assessed (Ps ≤ .008).

Conclusion: This brief intervention increased PCPs' self-reported valid use of the M-CHAT-R/F at 18 months and their self-efficacy regarding ASD care. Combining educational information with a web-based ASD screen incorporating the M-CHAT-R/F follow-up questions may increase universal ASD screening with improved fidelity.

Intervention Components (click on component to see a list of all articles that use that intervention): Media Campaign (Print Materials, Radio, TV), Screening Tool Implementation, Counseling (Parent/Family),

Intervention Description: Mass media advertisements; Targeted health promotion messaging; Community midwives screened all pregnant women for alcohol use in pregnancy (AUP); Increased focus of child health services on multidisciplinary developmental screening

Intervention Results: Alcohol use reduced significantly from 2010 (61.0%) to 2015 (31.9%) with first-trimester use reducing significantly from 2008 (45.1%) to 2015 (21.6%). Across all years, 40.8% reported alcohol use during pregnancy and 14.8% reported use in both first and third trimesters. Most women attended the midwife in the first trimester. There was a significant relationship between increased maternal age and third-trimester alcohol use.

Conclusion: The reduction in reported prenatal alcohol exposure in an Aboriginal community setting during a period of prevention activities provides initial evidence for a community-led strategy that might be applicable to similar communities. Implications for public health: The reductions in alcohol use reduce the risk of children being born with FASD in an area with high prevalence, with possible resultant reductions in associated health, economic and societal costs.

Study Design: retrospective analysis of administrative data collected from midwife paper records, pregnancy outcome records, and antenatal check-ups in the Fitzroy Valley and other areas of the Kimberley region in Western Australia.

Setting: Fitzroy Valley, which comprises approximately 3,500 predominantly Aboriginal people living in more than 40 remote communities in north-western Australia

Population of Focus: healthcare professionals, public health officials, policymakers, and researchers with an interest in prenatal alcohol exposure (PAE) and fetal alcohol spectrum disorder (FASD) prevention in Indigenous communities, community leaders, service providers and organizations involved in Aboriginal health.

Sample Size: 654 records with recorded midwife attendance

Age Range: 13-43 with a mean of 25.37 years old

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Referrals,

Intervention Description: The intervention involved the integration of an algorithm in the electronic health record (EHR) to determine eligibility for a PHQ-2 screening. Eligible patients were prompted for screening, and if the PHQ-2 score was ≥ 3, the PHQ-9 was integrated into the primary care provider workflow. For PHQ-9 scores ≥ 10, the EHR prompted the primary care provider with a referral order. A care manager then contacted the patient within 7 days to discuss symptoms and treatment options beyond medication. The care manager also provided brief cognitive behavioral therapy (CBT) or a community referral as well as case management while the patient was engaged in treatment. The primary care provider asked the patient to return for a follow-up visit in 6 to 8 weeks.

Intervention Results: Screenings, referrals, and uptake occurred proportionately across subgroups except for patients ages 12-17. Adolescent age was associated with disproportionate Patient Health Questionnaire-9 screenings and with treatment disengagement.

Conclusion: Yes, the study reports several statistically significant findings. For example, the study found that rates of screening, referrals, and uptake occurred proportionately across subgroups except for patients ages 12–17, where adolescent age was associated with disproportionate PHQ-9 screenings and with treatment disengagement. Additionally, the study found that although adolescents were disproportionately screened for the PHQ-9, they are not engaging in treatment (11%) compared to referred (21%) proportions of the sample (Cohen’s h = 0.28). The study also found that there were no meaningful differences across all demographic categories between proportions of eligible patients compared to screened patients, except for 12 to 17 year-olds.

Study Design: The study design is a retrospective analysis of electronic health record (EHR) data from primary care clinics where PHQ-2 and PHQ-9 screenings took place during routine office visits between November 2016 and December 2017,.

Setting: The study was conducted across 10 primary care clinics in a Chicago academic health center,.

Population of Focus: The target audience for the study includes healthcare professionals, researchers, and policymakers interested in collaborative care for depression in adults and adolescents, as well as those interested in addressing disparities in screening and treatment uptake for depression in primary care settings.

Sample Size: The study included a sample of 25,369 patients who were eligible for screening from November 2016 to December 2017.

Age Range: The age group mentioned in the study includes patients aged 12 and above. The study specifically highlights disparities in screening and treatment engagement for adolescent patients aged 12-17,.

Intervention Components (click on component to see a list of all articles that use that intervention): Quality Improvement, Provider Training/Education, Screening Tool Implementation,

Intervention Description: The intervention includes development of an educational video for maternity care providers, initiation of screening for postpartum anxiety using the anxiety subscale of the Edinburgh Postnatal Depression Scale (EPDS) 3. Implementation of a counseling tool to guide conversations with postpartum women who screen positive for postpartum anxiety 4. Provision of treatment and referral resources for postpartum anxiety, including lists of postpartum mental health specialists specific to their area. The intervention described aligns with a discernable strategy, which is to improve the screening, treatment, and referral of women with postpartum anxiety in the birth center environment. The study is a quality improvement project that analyzed a multicomponent intervention aimed at improving healthcare quality

Intervention Results: Among all screened participants, 12.58% had a positive EPDS-3A score of greater than six, indicating a positive screening for postpartum anxiety . 2. 6.98% of the participants had a EPDS score of less than 12 and an EPDS-3A score greater than six, indicating a positive anxiety screen and would have not received follow-up care if only screened for postpartum depression . 3. 9.7% of the participants were lost to follow-up and did not return for a postpartum visit when screening for postpartum anxiety would have been conducted . 4. The study demonstrated an overall postpartum anxiety screening rate of 86.3%, indicating increased awareness of the need for routine screening for postpartum anxiety among midwives . 5. The study also highlighted the importance of further modification of the Perinatal Data Registry to include the nature of treatment for patients who screen positive for postpartum anxiety, as well as the need for consideration of counseling and treatment for these patients . These results provide insights into the prevalence of postpartum anxiety among the screened participants and the challenges related to follow-up and treatment for those who screen positive for postpartum anxiety

Conclusion: The Edinburgh Postpartum Depression Scale -3A is a valid, easy-to-use tool which should be considered for use in clinical practice. Modification of the electronic health record can serve as an important impetus triggering screening and treatment. It is important that clinicians are educated on the prevalence of postpartum anxiety, its risk factors, symptoms and implications.

Setting: The setting for the study was 10 geographically diverse birth centers, and all members of the American Association of Birth Centers . These birth centers are largely staffed by certified nurse-midwives (CNMs) and certified professional midwives (CPMs) and primarily serve low-risk patients of varied race/ethnicity

Population of Focus: The target audience for the study includes healthcare professionals, particularly midwives and maternity care providers, as well as researchers and policymakers interested in postpartum mental health screening and interventions. Additionally, the findings may be relevant to organizations involved in maternal and child health, such as birth centers and midwifery associations

Sample Size: The study initially involved 11 birth centers, with a total of 387 participants across 9 participating sites. However, data from two sites were later removed due to lack of participation, resulting in a final sample size of 387 participants across 9 sites

Age Range: The age group of the participants in the study was not explicitly mentioned in the provided excerpts. Therefore, the specific age range of the participants is not available in the provided information.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Hospital Policies,

Intervention Description: The article describes the development and implementation of a standardized evidence-based PPD screening program in the NICU, which includes the use of the Edinburgh Postnatal Depression Scale (EPDS) as the screening tool, clear identification of the maternal depression evaluation and diagnosis plan, and designated private areas in the NICU as an option for maternal PPD screening. The intervention aligns with a discernable strategy of using a multidisciplinary team approach to develop and implement a PPD screening program in the NICU. The article describes a pilot program evaluation of the PPD screening program, which includes PPD screening of eligible consented mothers along with referral and follow-up according to the study protocol criteria. The study analyzes the effectiveness of the PPD screening program in the NICU, but it is not a multicomponent intervention study.

Intervention Results: The study found that NICU mothers are at a higher risk for postpartum depression (PPD) compared to mothers without infants in the NICU. The pilot program evaluation indicated inconsistent PPD screening practices from obstetric providers, strengthening the argument for incorporating maternal PPD screening as a routine process in the NICU. The results of the pilot program evaluation correlated with the literature review, estimating the frequency of PPD among NICU mothers to be over 40 percent . During the pilot program evaluation period, 161 infants were admitted to the NICU, and 45 of the infants admitted reached 30 days of age. The number of eligible mothers was reduced to 39. Out of the 39 eligible mothers, 13 scored 10 or greater on the EPDS, indicating a risk for depression. All 13 mothers scoring 10 or greater on the EPDS were provided with referral references, demonstrating compliance with the study protocol , . The study also highlighted the challenges faced by mothers in obtaining access to PPD diagnostic and follow-up, including limited time, lack of insurance, and future appointments with obstetric providers. The results emphasized the importance of providing support and reinforcement to mothers who had not obtained a follow-up appointment for an evaluation for PPD .

Conclusion: NICU mothers are at a higher risk for PPD compared to mothers without infants in the NICU. When their infant remains admitted to the NICU during PPD screening intervals recommended by the AAP, NICU mothers are not screened at well-child visits as the AAP intends. A multidisciplinary team convened to address the gap between current maternal PPD screening practices in the NICU and the AAP recommendations. The multidisciplinary team agreed that providing a PPD screening program in the NICU was an appropriate step to comply with the AAP screening recommendations. A pilot program evaluated the proposed process of screening for maternal PPD screening in the NICU, providing referral references and following up with mothers when screens indicated a risk for maternal depression. Results of the program evaluation indicated inconsistent PPD screening practices from obstetric providers, which strengthened the argument for incorporating maternal PPD screening as a routine process in the NICU. Findings from this program evaluation correlated with the literature review, estimating the frequency of PPD among NICU mothers is >40 percent. Although our sample was small and the study was limited to a single center, consistent challenges with maternal follow-up indicated that alterations in

Study Design: The study design involved the development and implementation of a pilot program to evaluate the process of maternal postpartum depression (PPD) screening in a single center neonatal intensive care unit (NICU). The pilot program aimed to mimic the PPD screening program developed by the NICU multidisciplinary team and included PPD screening of eligible consented mothers, referral, and follow-up according to the study protocol criteria. The study utilized a convenience sample of mothers of infants admitted to the NICU and involved a multidisciplinary team to discuss the progress of the PPD screening program. The pilot program evaluation protocol was submitted for review and was determined not to be human subject research, but was guided by a doctoral student's program implementation. The study was conducted over a short period of time in a single center NICU using a convenience sample, and the evaluation was limited by the doctoral student's eight-week implementation timeline and some infants' discharge from the NICU during the pilot program

Setting: The study was conducted in a 60-bed Level III neonatal intensive care unit (NICU) at a high-risk perinatology referral center in North Texas. The NICU admits an estimated 700 neonates annually, and the gestational ages of the NICU patients range between 22 and 42 weeks. The average length of stay in the NICU is 27 days. The study utilized a convenience sample of mothers of infants admitted to the NICU

Population of Focus: The target audience of the study is healthcare professionals, particularly those working in neonatal intensive care units (NICUs), who are involved in the care of mothers and infants. The study aimed to evaluate the process of maternal postpartum depression (PPD) screening in the NICU and to assess the effectiveness of a PPD screening program implemented in the NICU. The study findings may be useful for healthcare professionals involved in the care of mothers and infants in NICUs who are interested in implementing or improving PPD screening programs in their practice

Sample Size: The study involved a convenience sample of 30 mothers with infants who remained admitted to the NICU and consented to participate in the postpartum depression (PPD) screening pilot program. Out of the 30 mothers screened, 13 (43.3%) scored 10 or greater on the Edinburgh Postnatal Depression Scale (EPDS), indicating a risk for depression

Age Range: The study included mothers of infants admitted to the neonatal intensive care unit (NICU) who were 18 years of age or older. The maternal population was limited to those who were 18 years of age or older and fluent in English due to the lead investigator's communication capability with the use of a screening tool. NICU caregivers who did not give birth, spoke a language other than English, were less than 30 days from birth, and/or declined study participation were excluded from the study

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Office Systems Assessments and Implementation Training,

Intervention Description: The intervention in the study involved the use of a natural language processing (NLP)-based clinical decision support system embedded in the electronic health record (EHR) to identify potential surgical candidates among children with epilepsy. Patients identified as potential surgical candidates by the NLP were then randomized for their provider to receive an alert or no reminder prior to the patient's visit. The alerts were delivered through two modalities: half of the alerts were sent via email, and the other half were in-basket messages that appeared in the EHR. The primary aim of the intervention was to assess whether these automated alerts increased referrals for epilepsy surgery evaluations.

Intervention Results: Between April 2017 and April 2019, at total of 4858 children were screened by the system, and 284 (5.8%) were identified as potential surgical candidates. Two hundred four patients received an alert, and 96 patients received standard care. Median follow-up time was 24 months (range: 12-36 months). Compared to the control group, patients whose provider received an alert were more likely to be referred for a presurgical evaluation (3.1% vs 9.8%; adjusted hazard ratio [HR] = 3.21, 95% confidence interval [CI]: 0.95-10.8; one-sided p = .03). Nine patients (4.4%) in the alert group underwent epilepsy surgery, compared to none (0%) in the control group (one-sided p = .03).

Conclusion: Yes, the study reported statistically significant findings related to the impact of automated alerts on the referral patterns for epilepsy surgery evaluations. Specifically, the study found that providers were more likely to refer patients with epilepsy for a presurgical evaluation after receiving an automated alert. Furthermore, the study results indicated that the alerts significantly increased the likelihood of referral for presurgical evaluations, as evidenced by the statistical analysis using a Cox proportional hazards model to estimate the hazard ratio (HR) of referrals after receiving an alert and Wald's test to estimate the corresponding p-value. Additionally, the study reported statistically significant differences in the proportion of patients referred for presurgical evaluations and surgeries between the group that received alerts and the control group that did not receive alerts.

Study Design: The study design was a prospective, randomized controlled trial. The trial evaluated the effectiveness of a natural language processing (NLP)-based clinical decision support system embedded in the electronic health record (EHR) to increase referrals for epilepsy surgery evaluations. The study randomly assigned potential surgical candidates to either receive an automated alert or standard of care (no alert) prior to their scheduled visit. The primary outcome was referral for a neurosurgical evaluation, and the likelihood of referral was estimated using a Cox proportional hazards regression model. The study was conducted over a 2-year period, from April 16, 2017, to April 15, 2019.

Setting: The study was conducted at a large pediatric epilepsy center in Cincinnati, OH, USA, specifically at the Cincinnati Children's Hospital Medical Center (CCHMC). The providers involved in the study were attending neurologists and nurse practitioners from this center. The research was carried out at 14 pediatric neurology outpatient clinic sites affiliated with the hospital.

Population of Focus: The target audience for this study includes healthcare providers, particularly neurologists and nurse practitioners involved in the care of children with epilepsy. Additionally, researchers and professionals in the fields of medical informatics, natural language processing, and clinical decision support systems may also find this study relevant and valuable. Furthermore, healthcare administrators and policymakers interested in improving the utilization of referrals for epilepsy surgery evaluations, as well as those involved in the implementation of technology-based interventions in clinical practice, would benefit from the findings of this research.

Sample Size: The study included a total of 284 children with epilepsy who were identified as potential surgical candidates by the natural language processing (NLP) algorithm and were randomized 2:1 for their provider to receive an alert or standard of care (no alert). Of these, 96 patients were assigned to the control group, 93 whose treating provider received an email, and 95 whose treating provider received an EHR alert. The study was conducted over a 2-year period, from April 16, 2017, to April 15, 2019.

Age Range: The study does not focus on a specific age group. However, the patients included in the study were children with epilepsy who were being treated at Cincinnati Children's Hospital Medical Center. The age range of the patients is not specified in the article.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Hospital Policies,

Intervention Description: The intervention was the implementation of an evidence-based standard of care for the detection of PPD that can be implemented with every postpartum patient. The intervention included the use of the Edinburgh Postnatal Depression Scale-10 (EPDS-10) as a reliable and valid screening instrument for PPD. The intervention aligns with a discernable strategy, which is to improve screening practices for PPD in postpartum women. The strategy involved implementing an evidence-based standard of care that included the use of a validated screening tool, staff education, and process changes to ensure that every postpartum patient was screened for PPD. The PDF file describes a quality improvement project that analyzed the implementation of a single intervention, which was the use of the EPDS-10 as a screening tool for PPD. While the project involved multiple components, such as staff education and process changes, the focus of the study was on the implementation of the EPDS-10 and its impact on PPD screening rates.

Intervention Results: The study results indicated significant improvements in screening and referral of postnatal depression within the 8-week period compared to previous practices. Specifically, the implementation of the EPDS-10 led to increased screening rates, with documentation of screening rates ranging from 88% to 99% after the implementation. The study also found a significant increase in the detection and treatment of postpartum depression when a standardized, validated screening tool like the EPDS-10 was implemented. Additionally, the study reported that out of the patients screened, nine patients were detected for further assessment and treatment. The results also showed a significant increase in the percentage of patients screened, from 10.9% to 95.8%, and a significant decrease in the percentage of patients who were not screened, from 89.1% to 4.2%, after the implementation of the EPDS-10. These findings suggest that the implementation of the EPDS-10 positively influenced providers to be more consistent with screening and documentation practices, ultimately leading to improved detection, further assessment, and treatment of postpartum patients

Conclusion: This project established an evidence-based standard of care that can be implemented with every postpartum patient and brought nine women out of the shadows with the hope that they can find the light to recover from PPD.

Study Design: The study design used in the research described in the PDF file is a retrospective-prospective chart audit design. This design involved a formative evaluation of the process of implementation through weekly huddles and individual discussions with clinic staff and licensed clinicians to assess the new screening process and the use of the EPDS-10. Additionally, a retrospective chart audit of the electronic health record (EHR) was performed to determine the number of screenings performed 8 weeks before the implementation, and a prospective chart audit was conducted to determine how many charts had documented screenings during the 8 weeks of the implementation. The study design also involved the analysis of pre- and post-implementation data to evaluate the screening practices and determine if there was a significant difference in screening, detection, and treatment before and after the implementation of the EPDS-10.

Setting: The setting of the study described in the PDF file is a private practice obstetrics and gynecology (OBGYN) office in South Florida. The study focused on implementing the evidence-based standard of care for postpartum depression screening within this clinical setting. The organization consisted of multidisciplinary aggregate stakeholders, including licensed healthcare providers and non-licensed clerical staff, all of whom were involved in the implementation process.

Population of Focus: The target audience of the study described in the PDF file is healthcare providers and staff working in a postpartum ambulatory clinic, specifically in the obstetrics and gynecology (OBGYN) setting. The study aimed to improve the detection and treatment of postpartum depression (PPD) in women by implementing an evidence-based standard of care for PPD screening that can be implemented with every postpartum patient. The study also aimed to enhance the knowledge and competency of healthcare providers and staff in PPD screening, assessment, diagnosis, and treatment referrals.

Sample Size: The PDF file does not explicitly mention the number of participants involved in the study. However, it provides specific data related to the screening and treatment of patients before and after the implementation of the Edinburgh Postnatal Depression Scale-10 (EPDS-10). It mentions that out of the 55 patients who were seen before the implementation of the EPDS-10, 6 patients (10.9%) had documentation in the electronic health record (EHR) that a postpartum depression screening was performed. Additionally, it states that out of the 48 postpartum patients seen after the implementation, 46 were screened with the EPDS-10. While the exact number of participants is not explicitly provided, the study does present specific data on the outcomes of the intervention.

Age Range: The PDF file does not specify the age range of the participants involved in the study. The focus of the study is on the implementation of the Edinburgh Postnatal Depression Scale-10 (EPDS-10) as a screening tool for postpartum depression in women. Therefore, the age range of the participants is not explicitly mentioned in the provided content.

Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation, Hospital Policies,

Intervention Description: The intervention was the implementation of an evidence-based standard of care for the detection of PPD that can be implemented with every postpartum patient. The intervention included the use of the Edinburgh Postnatal Depression Scale-10 (EPDS-10) as a reliable and valid screening instrument for PPD. The intervention aligns with a discernable strategy, which is to improve screening practices for PPD in postpartum women. The strategy involved implementing an evidence-based standard of care that included the use of a validated screening tool, staff education, and process changes to ensure that every postpartum patient was screened for PPD. The PDF file describes a quality improvement project that analyzed the implementation of a single intervention, which was the use of the EPDS-10 as a screening tool for PPD. While the project involved multiple components, such as staff education and process changes, the focus of the study was on the implementation of the EPDS-10 and its impact on PPD screening rates.

Intervention Results: The study results indicated significant improvements in screening and referral of postnatal depression within the 8-week period compared to previous practices. Specifically, the implementation of the EPDS-10 led to increased screening rates, with documentation of screening rates ranging from 88% to 99% after the implementation. The study also found a significant increase in the detection and treatment of postpartum depression when a standardized, validated screening tool like the EPDS-10 was implemented. Additionally, the study reported that out of the patients screened, nine patients were detected for further assessment and treatment. The results also showed a significant increase in the percentage of patients screened, from 10.9% to 95.8%, and a significant decrease in the percentage of patients who were not screened, from 89.1% to 4.2%, after the implementation of the EPDS-10. These findings suggest that the implementation of the EPDS-10 positively influenced providers to be more consistent with screening and documentation practices, ultimately leading to improved detection, further assessment, and treatment of postpartum patients

Conclusion: This project established an evidence-based standard of care that can be implemented with every postpartum patient and brought nine women out of the shadows with the hope that they can find the light to recover from PPD.

Study Design: The study design used in the research described in the PDF file is a retrospective-prospective chart audit design. This design involved a formative evaluation of the process of implementation through weekly huddles and individual discussions with clinic staff and licensed clinicians to assess the new screening process and the use of the EPDS-10. Additionally, a retrospective chart audit of the electronic health record (EHR) was performed to determine the number of screenings performed 8 weeks before the implementation, and a prospective chart audit was conducted to determine how many charts had documented screenings during the 8 weeks of the implementation. The study design also involved the analysis of pre- and post-implementation data to evaluate the screening practices and determine if there was a significant difference in screening, detection, and treatment before and after the implementation of the EPDS-10.

Setting: The setting of the study described in the PDF file is a private practice obstetrics and gynecology (OBGYN) office in South Florida. The study focused on implementing the evidence-based standard of care for postpartum depression screening within this clinical setting. The organization consisted of multidisciplinary aggregate stakeholders, including licensed healthcare providers and non-licensed clerical staff, all of whom were involved in the implementation process.

Population of Focus: The target audience of the study described in the PDF file is healthcare providers and staff working in a postpartum ambulatory clinic, specifically in the obstetrics and gynecology (OBGYN) setting. The study aimed to improve the detection and treatment of postpartum depression (PPD) in women by implementing an evidence-based standard of care for PPD screening that can be implemented with every postpartum patient. The study also aimed to enhance the knowledge and competency of healthcare providers and staff in PPD screening, assessment, diagnosis, and treatment referrals.

Sample Size: The PDF file does not explicitly mention the number of participants involved in the study. However, it provides specific data related to the screening and treatment of patients before and after the implementation of the Edinburgh Postnatal Depression Scale-10 (EPDS-10). It mentions that out of the 55 patients who were seen before the implementation of the EPDS-10, 6 patients (10.9%) had documentation in the electronic health record (EHR) that a postpartum depression screening was performed. Additionally, it states that out of the 48 postpartum patients seen after the implementation, 46 were screened with the EPDS-10. While the exact number of participants is not explicitly provided, the study does present specific data on the outcomes of the intervention.

Age Range: The PDF file does not specify the age range of the participants involved in the study. The focus of the study is on the implementation of the Edinburgh Postnatal Depression Scale-10 (EPDS-10) as a screening tool for postpartum depression in women. Therefore, the age range of the participants is not explicitly mentioned in the provided content.

Intervention Components (click on component to see a list of all articles that use that intervention): Health_Care_Provider_Practice, Screening Tool Implementation Training, Provider Training/Education

Intervention Description: The REAL-START intervention aimed to increase primary care provider adherence to ASD and developmental screening guidelines, and to increase Early Intervention (EI) referral for children at developmental risk in primary care clinics serving Latinos. This quasi-experimental study enrolled 6 Oregon primary care clinics. Clinic staff attended one initial and three follow-up trainings.

Intervention Results: Initially, 2357 18- and 24-month visit records (1157 18-month and 1200 24-month visits) were reviewed. Of these, 134 records were excluded because the child was previously identified as having a developmental disability, missing language or ethnicity information, or no provider name recorded, resulting in a final analytic sample of 2224 records. Although the overall percentage of Latino children in the study was relatively high (39%), two clinics had unexpectedly lower rates of Latino children of screening age (10% and 18%, respectively) than predicted from baseline data. A total of 20% (n = 436) of families spoke Spanish as a primary language. EI referral data were followed for 381 children, of whom 216 were new referrals for “screening age” (15–28 month) children. Among children referred to EI, 47% were Latino and 30% spoke Spanish as a primary language. In total, 63% were Medicaid-insured, and 37% were female. Median age at EI referral was 19 months.

Conclusion: REAL-START, a yearlong screening intervention, was effective in increasing screening for autism spectrum disorder and general developmental delays, increasing therapy referrals, and shortening time for developmental assessment in primary care clinics with Latino patients.

Setting: Primary care clinics

Population of Focus: Primary care providers and staff

Intervention Components (click on component to see a list of all articles that use that intervention): Assessment, Screening Tool Implementation Training

Intervention Description: The article reviews literature on screening tools and strategies for early detection of autism spectrum disorder (ASD) in children aged 24 months and younger. It recommends that all children receive ASD-specific screening at 18 and 24 months using tools like the Modified Checklist for Autism in Toddlers (M-CHAT). It also suggests using broadband developmental screeners like the Communication and Symbolic Behavior Scales to assist ASD detection before age 2. Siblings of children with ASD should receive intensified developmental surveillance.

Intervention Results: Several ASD screening tools showed good sensitivity and specificity for detecting ASD risk around 18-24 months, including the M-CHAT, STAT, and FYI. The M-CHAT had a positive predictive value up to 0.65 in low-risk samples when combined with follow-up interviews. Studies indicate diagnoses of ASD around 24 months tend to be stable over time. However, challenges remain in implementing widespread ASD screening in pediatric practice due to time constraints, lack of reimbursement, logistical issues, and limited access to diagnostic and treatment resources.

Conclusion: The authors conclude that evidence supports the usefulness of ASD screening at 18-24 months using available tools, as recommended by the AAP. They call for further methodologically rigorous research on screening in representative samples, using meaningful long-term outcomes, and addressing barriers to widespread implementation in the healthcare system. Priorities include examining how to optimize screening strategies, such as combining broadband and ASD-specific tools, and considering use of biomarkers.

Study Design: N/A

Setting: N/A

Data Source: peer-reviewed articles published to December 2013

Sample Size: N/A

Age Range: N/A