There is substantive evidence of significant psychiatric illness among primary care patients, including older adults, mainly in anxiety and depressive disorders (Mitchell et al., 2009) and a marked proportion of primary care patients with behavioral and mental disorders remain unrecognized by their general practitioners (Joukamaa et al., 1994). It is essential that primary care health providers are able to quickly screen older patients for such disorders during routine appointments. Psychological and behavioral screening instruments- applied to measure/quantify behaviors and symptoms-are designed for that very purpose and are intended to be used as tools for screening mental illness and behavioral and cognitive problems in clinical settings. In the past decades many research projects have been conducted that have resulted in the development of behavioral and psychological screening instruments designed for use with older adults, often specifically within a medical setting. While these screening tools have been shown to be effective, most have not been well used or integrated into primary care settings. This project aims to translate the research findings and resulting instruments from those studies into everyday clinical practice and health decision-making in geriatric medicine. PsyScreen Sr.: Psychological Screening Instruments for Older Adults in Medical Settings, will result in the development of a mobile device application (tablet, iPad, smartphone), that will assist health care providers in identifyin and using appropriate screening instruments from a bank of carefully curated instruments designed specifically for use with older adults. The application allows for searching of the instrument bank, touch screen administration by physician or patient, provides guidelines for the health care provider based on results, and can optionally, provide tailored multimedia health education to the patient based on their answers. The health care provider can choose to trigger a standard set of assessments as part of the patient intake process, which can be self-administered by the patient or medical assistant, or the health care provider during the course of an appointment, can call upon the application to do a quick and effective screening, and provide immediate physician guidelines based on the results. In Phase I the project will develop 1) a needs assessment survey with medical professionals;2) a curated database of screeners designed specifically for use with older adults related to mental and behavioral health, including the identification of mental and behavioral health topical areas and screener domains of most interest to health care providers;3) a prototype version of the product which will include three sample screeners, including the search interface, automated and fully audio enhanced screener for use on the touch screen mobile device, multimedia educational content for the patient based on screener results, and physician guidelines based on patient responses;and 4) usability test of the prototype with older adults and medical professionals.
This project, PsyScreen Sr., will result in the development of a mobile device application which would assist health care providers in identifying and using appropriate psychological and behavioral screening instruments from a bank of carefully curated instruments designed for use with older adults. The application allows for searching, touch screen administration by the health care professional or patient, provides guidelines for the health care provider based on the test results, and can optionally provide tailored multimedia health education to the patient based on their answers to the screening instrument. This project will promote public health in several ways. First, it will offer older adults increased access to mental and behavioral health screenings and corresponding education during routine health care appointments, and second, it will improve the accuracy of mental and behavioral health diagnosis and quality of care provided by physicians practicing primary care and geriatric medicine for these older patients. Additionally, the project translates results from previous clinical studies into everyday clinical practice and health decision-making in geriatric medicine, harnessing and expanding on prior studies that resulted in the development of effective behavioral and psychological screening tools designed specifically for use with older adults, with many designed specifically for use in primary care settings. These screening tools cover an array of public social and behavioral concerns often seen in primary care settings, such as alcohol use/misuse, nicotine dependence, depression, sexual health risk, functional decline, and pain assessment. While these screening tools have been shown to be effective, many have not been well used or integrated into primary care settings.