Does an education intervention improve behavioural intent to screen for depression : a feasibility study

Abstract

BACKGROUND Depression affects one in five New Zealanders and often goes without recognition, or effective treatment. Screening has the potential to improve detection of depression, however, screening for depression within New Zealand osteopathy is poorly implemented. Addressing the lack of knowledge with depression screening has been found to improve osteopaths’ detection of depression and referral for appropriate treatment. This study’s primary objectives were to determine if it was feasible that a behaviour change education intervention, using the Whooley questions, for depression screening could influence student osteopaths’ readiness to change, commitment and clinical behavioural intention within clinical practice. The study investigated student osteopaths’ perceptions and experiences of the behaviour change intervention, including the use of Whooley questions in a clinical setting.

METHODS This was a non-randomised prospective feasibility study which incorporated mixed methods to form two studies. The main quantitative study included a pre-post questionnaire survey of an education session on depression screening and post questionnaire survey of depression screening after six weeks of clinical practice. The second, supportive qualitative study was informed by interpretive description and thematic analysis.

RESULTS The quantitative data revealed significant gains in the osteopathic students’ clinical behaviour intentions to screen for depression as well as in their perceptions of willingness to change. Their belief in the need to change their screening behaviours and the benefits of such change also improved significantly. Spearman’s rho showed a significant positive correlation of large magnitude between students’ initial commitment to screen for depression in comparison to their final intention score to screen for depression, following six weeks of screening practice. Qualitative data suggested the education session encouraged positive behaviour change regarding the adoption of depression screening. The Whooley questions were found to be a useful screening tool, and patients who responded positively to the Whooley questions were able to be appropriately referred on. Finally, reminder screening cards were perceived to be a key tool for facilitating behaviour change and depression screening in a clinic setting.

CONCLUSION Preliminary evidence demonstrates that a brief educational intervention designed to train student osteopaths in screening for depression could be feasible and may improve students’ readiness to change and commitment, and clinical behavioural intent within clinical practice. The education session was perceived to be relevant and informative for screening for depression. After six weeks of screening for depression, students felt they were able to appropriately screen patients with possible depression, and some did refer patients for an accurate diagnosis and treatment.