Adapting an Adolescent Depression Prevention Program for Pediatric Primary Care.

OBJECTIVE

The purpose of this study was to adapt an evidence-based adolescent depression prevention program, Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST), in collaboration with families, clinicians, and topical experts to maximize its acceptability and fit with the primary care setting.

METHODS

Semi-structured qualitative interviews were conducted with adolescents who scored in the subthreshold range on a depression screener at a recent primary care well visit (n=10; Mage=15.13 years, SD=1.72; 60% female; 70% Black, 20% Hispanic/Latino), their caregivers (n=10, 90% female, 80% Black, 10% Hispanic/Latino), and clinicians (n=10; 100% female; 40% Black, 0% Hispanic/Latino). Participants shared their views on adolescent depression prevention broadly as well as IPT-AST specifically and gave feedback on potential modifications to IPT-AST that were generated by the research team. Experts in depression prevention/treatment, primary care, and policy (n=25) provided input on simple mockups of the adapted program.

RESULTS

Rapid qualitative analyses of interviews indicated clinicians and families believe adolescent depression prevention is important and feedback on IPT-AST was positive. Yet, results confirmed the need to consider adaptations, such as reducing the length and number of sessions, to enhance feasibility. Topical experts gave guidance on ways to incorporate interviewee feedback into adaptations while preserving the core elements of IPT-AST.

CONCLUSIONS

Results will inform adaptations to IPT-AST to better align with the needs and preferences of families and clinicians in primary care, thereby hopefully improving access to adolescent depression prevention programming in this setting. The adaptations can guide future development and/or refinement of other mental health programs for primary care.