Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Dr. Vanessa Loyd, College of Nursing


Dr. Vanessa Loyd, DNP, PhD, RN

Dr. Nancy M. Magnuson, DSN, APRN, PCNS, FNP-BC

Judy Bentley, CEO, WHNP, MA, RN


Problem: Uninsured African Americans are underdiagnosed and often untreated for depression. Individuals usually do not present to their primary care provider with a complaint of depressed mood, however, may report symptoms such as decreased energy, general body aches, digestive concerns, somatic complaints, or older adults' memory or cognitive problems. The purpose of this quality improvement pilot project was to examine the results of the implementation of a depression screening (PHQ-9) in a primary care setting for uninsured adults for detection, diagnosis, and treatment of depression in African American clients.

Results: The PHQ-9 screening questionnaire was given to 100% (N=24) of new clients seen over three months. There were 16.6% (n=4) whites and 83.3% (n=20) African Americans. Of the African American clients 25% (n=5) scored 10 –14 indicating moderate depression; 5% (n=1) scored six points signaling mild depression; 70% (n=14) scored zero suggesting none to minimally depressed. Providers reviewed all client’s results and recommended either treatment, counseling, or medication.

Implications for Practice: Utilization of the PHQ-9 screening questionnaire with uninsured African American clients in primary care resulted in an increase in the number of African Americans diagnosed and treated for depression. Incorporating depression screening with the initial primary care visit can be beneficial.