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Currently accepted at: JMIR Human Factors

Date Submitted: Apr 24, 2025
Date Accepted: Jan 19, 2026

This paper has been accepted and is currently in production.

It will appear shortly on 10.2196/76230

The final accepted version (not copyedited yet) is in this tab.

“Helpful in Thinking Through the Question": Re-designing the PHQ-8 for Depression Assessment to Enhance Patient Engagement and Understanding

  • Hannah Dorris; 
  • Jenna Sheldon; 
  • Courtney Sepucha; 
  • Emmanuel Kasuti Makau; 
  • Pape Sow Traoré; 
  • Nicholas Jacobson; 
  • Elizabeth Murnane

ABSTRACT

Background:

Major Depressive Disorder (MDD) is a prevalent and impairing mental health condition characterized by persistent low mood, diminished energy, and disrupted sleep. Self-report instruments, such as the PHQ-8, are frequently used in clinical and research settings for depression assessment. However, repeated administration of these tools may lead to survey fatigue, diminished patient engagement, and misunderstanding of survey-item content, undermining patient satisfaction and compromising the validity of the responses.

Objective:

The objective of our study was to address these limitations, so we developed, redesigned, and tested two new versions of the PHQ-8, incorporating visualizations and reframed statements aimed at improving acceptability and comprehension.

Methods:

In a mixed-methods study, 20 participants with high subclinical to moderately severe depressive symptoms provided feedback after completing three versions: the standard PHQ-8 form, our version augmented with visual aids, and our version that combined visual aids with rephrased item statements for greater clarity and engagement.

Results:

Results showed that 80% of participants expressed a preference for the augmented PHQ-8 over the traditional PHQ-8 that was statistically significant, where p was equal to 0.006.

Conclusions:

Participants cited their preference for the augmented PHQ-8 was related to improved understanding, ease of use, and engagement.


 Citation

Please cite as:

Dorris H, Sheldon J, Sepucha C, Makau EK, Traoré PS, Jacobson N, Murnane E

“Helpful in Thinking Through the Question": Re-designing the PHQ-8 for Depression Assessment to Enhance Patient Engagement and Understanding

JMIR Human Factors. 19/01/2026:76230 (forthcoming/in press)

DOI: 10.2196/76230

URL: https://preprints.jmir.org/preprint/76230

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