Virtual coaching lifts adolescent health screening

A routine adolescent checkup became a little more likely to catch warning signs. Across 27 pediatric primary-care clinics in 18 states, a virtual initiative led by UC Davis Health, the American Academy of Pediatrics and partner organizations increased screening for substance use and mental-health concerns during an 11-month program.

The TEAMSS collaborative — Transformative and Evidence-based Approaches to Mental Health and Substance Use Screening — involved 160 clinicians caring for adolescents ages 12 to 18. Substance-use screening rose from 35% to 75% of adolescent well visits, and follow-up after a positive screen increased from 69% to 86%. Depression screening reached 90% from 82%; anxiety screening reached 69% from 32%; and suicide-risk screening reached 41% from 18%.

The mechanism was practical rather than exotic. Clinics received short virtual learning sessions, individualized coaching, peer-to-peer learning, feedback on their data and tools to redesign workflows. They added standardized protocols, validated questionnaires such as CRAFFT, PHQ-9 and GAD-7, electronic-health-record integration, mobile-device screening, broader care teams and referral partnerships. Ulfat Shaikh, a UC Davis Health pediatrics professor and the study's lead author, said the approach helped teams build systems that could survive beyond the project.

And concretely? More adolescents could be identified during ordinary primary-care visits, with a greater chance of follow-up after a positive substance-use screen. The virtual model also allowed clinics across the country to participate regardless of geography, according to Shaikh. Nine months after the collaborative ended, 85% of clinics reported that they had fully maintained the changes, suggesting that the intervention was not limited to a temporary campaign.

The limits are clear. Suicide-risk screening, though improved, remained below the levels reached for depression and substance use. The researchers called for stronger community partnerships and more support for rural and resource-limited clinics. More than 90% of participating clinicians reported better care or clinic operations, but these results describe the TEAMSS participants; the study does not establish that every primary-care clinic would achieve the same gains.