ABSTRACT
Project ADAPT: Outcomes of a geriatric depression assessment and
treatment program in rural primary care settings
Merrie Kaas, DNSc, RN, U of M School of Nursing; Anne Kane, MPH, U of M School of Public
Health; Margaret Artz, PhD, U of M College of Pharmacy; Robert Kane, MD, U of M School of
Public Health
Education and quality improvement interventions have been designed and tested to improve
screening, assessment and treatment of geriatric depression in primary care. Various research
utilization studies have attempted to reduce the gap between the existing evidence for geriatric
depression treatment and clinical practice. Often these studies funded additional clinical staff to
conduct the interventional research; but once the funding ended, the new clinical practice was
not sustainable. but few of these projects have been adapted to meet the needs of primary clinics
in rural areas. The purpose of this presentation is to describe Project ADAPT, a depression
screening and treatment program for elders in rural primary care settings.
Project ADAPT (Assessing Depression and Proactive Treatment) aimed to develop educational
materials about geriatric depression, train rural health care providers to screen, assess, and treat
geriatric depression using Project ADAPT protocols, and pilot test the implementation of Project
ADAPT practice model in rural primary care clinics. Project ADAPT ‘s focus was to utilize
existing clinic resources to overcome issues of sustainable new practice models.
Twenty-four rural health care settings serving 50 older adults or more per month participated in
Project ADAPT in some way. Although Project ADAPT educational materials and staff training
were designed for health care providers in primary care clinics, ADAPT participants came from
LTC settings, hospitals, home care and public health and service agencies. Participants reported
that ADAPT training improved depression screening and follow up assessment but not treatment.
Project ADAPT outcomes suggest that provider, patient and service system barriers need to be
addressed differently in rural than in urban areas, and that reorganizing a health care system may
be a more efficient way of closing the gap between evidence and practice but it is a lot harder
than changing clinician behaviors.
University of Minnesota School of Nursing Annual Research Day
April 21, 2006