Date of this Version

2025

Document Type

DNP Project

Abstract

Depression is a prevalent comorbidity in individuals with Type 2 Diabetes Mellitus (T2DM), affecting up to 30% of this population and contributing to poor glycemic control, increased complications, and decreased adherence to treatment regimens. Despite evidence supporting the integration of mental health care in diabetes management, depression screening remains underutilized in primary care settings due to workflow challenges, insufficient provider training, and limited integration of behavioral health services. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to implement and evaluate a standardized depression screening and management protocol for adult patients with T2DM in a South Florida primary care clinic. The intervention involved patient and provider education, systematic use of the Patient Health Questionnaire-2 (PHQ-2) and Patient Health Questionnaire-9 (PHQ-9), and insurance of streamlined referrals to behavioral health services. Screening rates, referral completion, and patient outcomes such as PHQ-9 scores and glycemic control (HbA1c, pre- and postprandial blood glucose levels) were tracked over a 4-week period. Informed by the health belief model, the project emphasized the role of perceived benefits, barriers, and selfefficacy in facilitating behavior change among patients and providers. A pre/post-test design was used. Descriptive and inferential statistics were used to analyze baseline data from 10 participants. One patient screened positive on the PHQ-2 and was found to have moderately severe depression based on the PHQ-9, resulting in a timely referral to behavioral health services. The mean HbA1c across participants was 8.08%, indicating suboptimal glycemic control. Although statistical tests revealed no significant associations between age, gender, and HbA1c levels, findings underscore the feasibility 3 and value of incorporating depression screening into routine diabetes management. This project demonstrates the potential of structured screening to improve integrated care delivery and patient outcomes in high-risk populations.

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