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Depression Screening Patterns for Women in Rural Health Clinics


  • Funding for this study was provided by the US Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy, grant no. 1 R04RH01306-01 and the Department of Family Medicine, East Tennessee State University. The authors are solely responsible for the content. For further information, contact: Fred Tudiver, MD, East Tennessee State University, Dept. of Family Medicine, Campus Box 70621, Johnson City, TN 37614; e-mail


Context: Rates and types of screening for depression in rural primary care practices are unknown.

Purpose: To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs).

Methods: A chart review of 759 women's charts in 19 randomly selected RHCs across the nation. Data were collected from charts of female patients of rural primary care providers, using trained data collectors (inter-rater reliability .88 to .93). The Women's Primary Care Screening Form, designed by the authors, was used to collect demographic, health, and screening data. Data describing the characteristics of the clinics were collected using the National Rural Health Clinic Survey. Data regarding formal screening (validated instrument used) or informal (documentation of specific questions and answers regarding depression) in the previous 5 years were recorded.

Findings: Characteristics of participating clinics and demographics of the women were similar to published data. Formal screening was documented in 2.4% of patients’ charts. Informal screening was documented in 33.2% of charts. Patients with a history of anxiety were more likely to be screened (P < .001), and younger women were more likely to be screened than older women (P < .001).

Conclusions: Primary care providers in RHCs use more informal than formal depression screening with their female patients. Providers are more likely to screen younger patients or patients with a diagnosis of anxiety.