title: eCHAT for lifestyle and mental health screening in primary care.
abstract: OBJECTIVE
  Early detection and management of unhealthy behaviors and mental health issues in primary care has the potential to prevent or ameliorate many chronic diseases and increase patients' well-being. This study aimed to assess the feasibility and acceptability of the systematic use of a Web-based eCHAT (electronic Case-finding and Help Assessment Tool) screening patients for problematic drinking, smoking, and other drug use, gambling, exposure to abuse, anxiety, depression, anger control, and physical inactivity, and whether they want help with these issues. Patients self-administered eCHAT on an iPad in the waiting room and received summarized results, including relevant scores and interpretations, which could be by a family physician on the website and in the electronic health record (EHR) at the point of care.
  
  
  METHODS
  We conducted a mixed method feasibility and acceptability study in 2 general practices in Auckland, New Zealand. Participants were consecutive adult patients attending the practice during a 2-week period, as well as all practice staff. Patients completed eCHAT, doctors accessed the summarized reports. Outcome measures were patients' responses to eCHAT, and patients' written and staff recorded interview feedback.
  
  
  RESULTS
  Of the 233 invited patients, 196 (84%) completed eCHAT and received feedback. Domains where patients wanted immediate help were anxiety (9%), depression (7%), physical activity (6%), and smoking (5%), which was not overwhelming for physicians to address. Most patients found the iPad easy to use, and the questions easy to understand and appropriate; they did not object to questions. Feedback from 7 doctors, 2 practice managers, 4 nurses, and 5 receptionists was generally positive. Practices continue to use eCHAT regularly since the research was completed.
  
  
  CONCLUSIONS
  eCHAT is an acceptable and feasible means of systemic screening patients for unhealthy behaviors and negative mood states and is easily integrated into the primary care electronic health record.
authors.affiliation: Department of General Practice & Primary Health Care, Faculty of Medicine & Health Science, University of Auckland, New Zealand.
authors.forename: Felicity
authors.initials: F
authors.lastname: Goodyear-Smith
authors.forename: Jim
authors.initials: J
authors.lastname: Warren
authors.forename: Minja
authors.initials: M
authors.lastname: Bojic
authors.forename: Angela
authors.initials: A
authors.lastname: Chong
mesh_terms: D019973:Alcohol-Related Disorders / Q000175:diagnosis; D001007:Anxiety / Q000175:diagnosis; D001291:Attitude of Health Personnel; D003863:Depression / Q000175:diagnosis; D005715:Gambling / Q000175:diagnosis; D015438:Health Behavior; D006801:Humans; D020407:Internet; D001523:Mental Disorders / Q000175:diagnosis*; D009043:Motor Activity; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000379:methods*; D057185:Sedentary Behavior; D012907:Smoking; D011795:Surveys and Questionnaires; D014754:Violence
keywords: life style; mass screening; mental health; primary health care; risk reduction behavior
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