Behavioral Health

Screening for Depression in Primary Care

There is a high degree of comorbidity amongst people with major depression and diabetes. Comorbidity impacts treatment adherence, enhances the risk of serious health problems (such as blindness, amputation, stroke, and premature mortality) and increases healthcare use. Rates of screening for depression in primary care vary but are low for patients with no pre-existing history of depression.

This study will examine rates of screening and management of depression in primary care to inform the implementation of one or more interventions to increase rates of screening and the use of evidence-based interventions, such as collaborative care models or motivational interviewing.

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4 Rs and 2 Ss Family Strengthening Program

Disruptive Behavior Disorders (DBDs) are common, chronic and impairing conditions associated with significant burden to children, their families and society. Up to 15% of children and adolescents experience DBDs, with children living in poverty-impacted communities at the highest risk for DBDs. The 4Rs and 2Ss Family Strengthening Program – developed by Brown School Dean Mary McKay – is a family-centered, group delivered intervention that supports youth with DBDs and their caregivers.

Previous research, led by Dean McKay and Mary Acri, found that participants receiving the 4Rs and 2Ss intervention reported significantly less child inattention symptoms, descriptions of their child’s behavior as difficult, as well as less personal and childrearing stress, compared to the comparison groups, and that participants receiving 4Rs and 2Ss reported significant reductions in caregiver depression, parenting stress, parent-child dysfunctional interaction, and caregiver minimization of problems over time.

The current analysis uses data from a recently concluded 4Rs and 2Ss implementation study that included eighty-five clinics and 1,546 caregiver/child dyads to examine what factors predict completion of the intervention program versus early dropout by caregivers. The findings from this analysis can help inform future implementation of the 4Rs and 2Ss program to better serve caregivers and their children.