- Implementation of the Focus on ME (FOM) learning collaborative across 20 Ohio primary care practices improved evidence-based screening and management for women's behavioural health.
- Compared to baseline, 12-month FOM implementation produced immediate sustained increases in GAD-7 screening by 23.1% and PHQ-9 screening by 18.1%.
- Protocol-aligned treatment rose substantially: anxiety PAT increased 25.9% and depression PAT increased 38.0%, supporting further scaling evaluation.
J Gen Intern Med. 2026 Jul 30. doi: 10.1007/s11606-026-10657-3. Online ahead of print.
ABSTRACT
BACKGROUND: Compared to other adults, US women of reproductive age are more likely to experience anxiety and depression; primary care interventions are needed to address barriers to evidence-based screening and treatment.
OBJECTIVE: To examine rates of evidence-based screening and management of anxiety and depression in primary care associated with implementation of a women’s behavioral health quality improvement learning collaborative, Focus on ME (FOM).
DESIGN: An interrupted time series analysis assessed changes from baseline and changes in trends related to anxiety and depression screening and treatment after a positive screen before (January 1, 2021-February 28, 2022) and during (March 1, 2022-February 28, 2023) implementation.
PARTICIPANTS: Women aged 18-44 within 20 Ohio primary care practices participating in FOM.
INTERVENTIONS: FOM implemented a primary care behavioral health screening and management protocol developed with clinical experts and aligned with clinical guidelines, using a learning collaborative aligned with the Institute for Healthcare Improvement’s Breakthrough Series model.
MAIN OUTCOME MEASURE(S): Primary outcomes: (1) change in practice-level Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) screening and (2) percentage of patients who received protocol-aligned treatment (PAT) after a GAD-7 score ≥ 10 or PHQ-9 score ≥ 15.
KEY RESULTS: FOM practices delivered 19,126 visits to women aged 18-44 across pre-implementation (13,247) and implementation (11,911), averaging 2245 visits/month. A total of 9448/19,126 (49.4%) of visits were with Medicaid beneficiaries. Compared to pre-implementation, the 12-month FOM implementation period showed immediate and sustained increases in GAD-7 (change from baseline = 23.1% p < 0.05) and PHQ-9 (change from baseline = 18.1%, p < 0.001) screening, as well as PAT for anxiety (change from baseline = 25.9%, p < 0.05) and depression (change from baseline = 38.0%, p < 0.001).
CONCLUSIONS: FOM implementation was associated with improvements in screening and treatment of anxiety and depression across a statewide network and warrants broader scaling investigation.
PMID:42533266 | DOI:10.1007/s11606-026-10657-3
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