End-user views of an electronic encounter decision aid linked to routine depression screening

Patient Educ Couns. 2019 Mar;102(3):555-563. doi: 10.1016/j.pec.2018.10.002. Epub 2018 Oct 3.


Objective: Our aim was to gather community stakeholder input to inform the development of a digital system linking depression screening to decision support.

Methods: Views and feature requirements were identified through (1) focus groups with patients and consumers with depression, and interviews with primary care clinicians and (2) usability sessions where patients and consumers used the current version of encounter decision aid (eDA) in a primary care waiting room. Qualitative data were analyzed using the framework method.

Results: We conducted six focus groups with 15 participants, seven clinician interviews and 10 usability sessions. Patients were comfortable completing the Patient Health Questionnaire (PHQ-9) and receiving the electronic eDA in clinic. They felt this would allow patients to prepare for their visit and instill a sense of agency. Participants were comfortable receiving the PHQ-9 results and a subsequent eDA on a tablet in the waiting room.

Conclusion: Patients with and without depression, as well as clinicians, viewed linking the PHQ-9, results, and eDA positively. Patients were comfortable doing this in the clinic waiting room.

Practice implications: Linking depression decision support to screening was viewed positively by patients and clinicians, and could help overcome barriers to shared decision-making implementation in this population.

Keywords: Community engagement research; Decision aid; Depression; Implementation; Primary care; Screening; User-centered design.

MeSH terms

  • Community-Based Participatory Research
  • Decision Making*
  • Decision Support Techniques*
  • Depression / diagnosis
  • Female
  • Focus Groups
  • Humans
  • Interviews as Topic
  • Male
  • Mass Screening
  • Patient Participation / methods*
  • Primary Health Care / methods*
  • Program Development