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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Victoria Britson


depression, rural, primary care, depression screening, Patient Health Questionnaire


In the United States (US), less than half of the population suffering from depression is receiving adequate treatment (National Alliance on Mental Illness [NAMI], 2017). For individuals residing in rural communities, a number of disparities have impaired accessibility to resources necessary for managing depression. Nearly 50% of patients suffering from depression go undetected in primary care settings and less than five percent of the population is screened despite recommendations (American Psychological Association [APA], 2017b; Canady, 2017). This DNP project aimed to evaluate whether standardized depression screening using the Patient Health Questionnaire (PHQ-9) increases the identification of patients with undiagnosed and/or untreated depression in the rural primary care setting. A standardized screening process was implemented over a two month period and the number of depression diagnoses made pre- and post-implementation were compared. Prior to implementing standardized screening, 844 patients were seen in the clinic over a two month period and 24 new depression diagnoses were made. During implementation 858 patients were seen in the clinic and 23 new depression diagnoses were made (p = 0.837). Gender differences were found, in which women constituted 78% of the depression diagnoses made during the implementation period. Despite limitations within the project, the findings concluded that depression screening is a simple and cost-effective intervention that, although not statistically significant, is clinically significant and relevant.

Library of Congress Subject Headings

Depression, Mental -- Diagnosis.
Medical screening.
Rural health.


Includes bibliographical references



Number of Pages



South Dakota State University


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