HEEADSSS Up: The Popular Screening Tool Comes to Mobile Devices

In a busy primary care practice, providers often encounter adolescents and young adults. Frequently, these visits are “only” for sports physicals and acute/minor illness visits. Many times providers will fail to dive into personal issues with these patients. Whether this is simply due to a lack of time and/or a lack of knowledge of how to screen for psychosocial issues, we frequently miss opportunities with these patients. Furthermore, adolescents and young adults do not come to see their primary care provider as frequently as other age groups. Therefore, providers need a systematic method to evaluate for psychosocial issues in adolescents and young adults in order to take advantage of each and every opportunity. In the early 1990s, the HEEADSSS screener was developed by Dr. JM Goldenring and colleagues. HEEADSSS stands for: Home, Education/Employment, Eating, Activities, Drugs, Sexual health, Suicide and Safety. Since the initial release the questions were updated in 2004, and more recently in 2014, a 3.0 version involving more social media based questions was developed. The app is advocated by most national groups including the American Academy of Pediatrics. Most providers are taught this screening tool in medical school or residency.

A team of providers in the UK with a grant from Health Education England has brought the HEEADSSS screening to mobile devices via an interactive app. The app can be used anywhere in the world, but the developers have customized it to England. When you first log into the app (which requires your name and email address for unknown reasons), it prompts you to select which region in England you practice medicine. Once you begin the screening, the app asks you if you discovered any issues for a particular domain. If you select “yes,” the app provides links to national and regional resources specific to that HEEADSSS domain. It works flawlessly! Furthermore, you can text or email these resources to your patient. If only we had something like this for the United States by zip code!

 

Evidence-based medicine

The HEEADSSS screening tool has been used since the 1990s to evaluate for psychosocial issues primarily in adolescents and young adults (ages 10-24). The acronym is used worldwide and advocated in the United States by the American Academy of Pediatrics and others as the gold standard for psychosocial screening as part of routine care. Although not validated in the same sense as say a diagnostic test, HEEADSSS has been used extensively in research with numerous publications on PubMed which utilize it as a screening tool.

What providers would benefit from this app?

Students, residents, mid-levels, pediatrics, adolescent medicine, family medicine, behavioral health providers. The app could really benefit any provider who sees adolescents and young adults.

Price

o Free.

Likes

o HEEADSSS screener now in easy-to-use app format.

o Regional/national resources for each section; can text/email resources to patients.

o Available for Android.

Dislikes

o Resources limited to England.

o Not much information listed for each resource.

o Email address necessary for app registration.

Overall

The HEEADSSS app is a perfect tool for adolescent medicine in England. The app is an outstanding example of taking a basic screener like HEEADSSS and improving upon it via the regional and national resources for each section of the acronym. Even though the app may seem only applicable to providers in England, the HEEADSSS acronym is used around the world so this app is a fantastic tool for all primary care providers.

Overall Score

o 4.5 stars.

User Interface

o 4.5 stars.

Easy to use, includes instructions provided within the app; resources easy to access.

Multimedia Usage

o 4.5 stars.

The app is filled with links to regional and national resources based on each HEEADSSS section. App permits texting and emailing of resource materials to patients.

Price

o 5 stars.

App is free.

Real World Applicability

o 4.0 stars.

The HEEADSSS app is an easy-to-use, free, validated screening tool for adolescent medicine. The app is ideal for providers in England since all of the resources included in the app are divided by regions located in England. However, the questions are universal and the app would serve as an excellent point of care tool for providers seeing adolescent patients. Would love to see a similar app for the United States.

Device Used For Review

o iPhone 8 running iOS 12.2.

Available for Download for iPhone, iPad, and Android.

Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.