Leveraging Technology to Promote Skill Utilization and Enhance Treatment Outcomes in Young Adolescents with ADHD

利用技术促进多动症青少年的技能利用并提高治疗效果

• 批准号: 10517492
• 负责人: Melissa Renee Dvorsky
• 金额: $ 16.14万
• 依托单位: CHILDREN'S RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-11-15 至 2024-11-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10517492
• 关键词: Address; Adherence; Adolescence; Adolescent; Adult; Affect; Aftercare; Age; Attention; Attention deficit hyperactivity disorder; Award; Behavior Therapy; Behavioral; California; Caring; Childhood; Clinical Sciences; Clinical Trials; Compensation; Data; Development; Development Plans; Effectiveness; Enhancement Technology; Evaluation; Executive Dysfunction; Family; Feedback; Financial Hardship; Focus Groups; Funding; Future; Goals; Grant; Health Personnel; Health Technology; Hyperactivity; Impairment; Intervention; Intervention Trial; Interview; Laboratories; Learning; Life; Maintenance; Mechanics; Mental Health; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Modality; Monitor; Motivation; National Institute of Mental Health; Outcome; Parents; Pathway interactions; Performance; Phase; Positioning Attribute; Positive Valence; Process; Protocols documentation; Provider; Psychological reinforcement; Recommendation; Research; Research Personnel; Research Support; Resources; Rewards; Risk; San Francisco; School Drop-Outs; Schools; Severities; Short-Term Memory; Social support; Societies; Strategic Planning; Student Dropouts; System; Technology; Testing; Time; Training; Translational Research; Treatment outcome; Universities; Validation; Work; Writing; Youth; acceptability and feasibility; adaptive intervention; behavior change; care costs; career; career development; cognitive process; cognitive system; computer human interaction; contingency management; design; digital; digital health; digital tool; digital treatment; effectiveness trial; empowerment; evidence base; executive function; experience; follow-up; forgetting; functional disability; improved; in vivo; innovation; interactive tool; intervention effect; intervention refinement; mobile computing; novel; personalized strategies; programs; reduce symptoms; research data dissemination; response; reward processing; skills; social; substance use; theories; therapy design; therapy development; tool; treatment adherence; treatment optimization; treatment research; treatment response; trial comparing; usability; user centered design

PROJECT SUMMARY/ABSTRACT While evidence-based behavioral treatments for adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) are well-established, these interventions most often fail to generalize across settings and are associated with intervention effects that dissipate over time. The current proposal takes a theory-driven, empirical approach for optimizing existing behavioral treatment by targeting adolescents’ skills utilization and engaging other modifiable factors associated with trajectories of ADHD-related impairment including reward sensitivity, motivation, executive functioning, and social support. Mobile technologies offer transformative opportunities for engaging these targets and overcoming the notorious challenges impeding treatment adherence for adolescents with ADHD. This mentored K23 award will support the candidate in developing an independent research career investigating innovative approaches for optimizing treatment response for youth with ADHD. This K23 is designed to provide the necessary training to become an expert in leveraging technology-enhanced resources to target behavioral skill utilization in order to enhance treatment response and promote sustained improvement. This award will provide the candidate with advanced training in: (1) interactive health technologies; (2) adherence promotion; (3) methods and statistical approaches for ecological valid, real time assessment and adaptive intervention designs; and (4) mechanism-based intervention refinement and evaluation; and (5) grant writing skills and research dissemination. Through the University of California, San Francisco (USCF) Laboratory for Hyperactivity, Attention, and Learning Problems (HALP) and the UCSF’s Clinical and Translational Science Institute (CTSI) Award, the candidate is uniquely equipped with resources to achieve her training objectives and complete this research. The mentorship team includes senior level investigators with active federally-funded research, experience mentoring early-career investigators, and expertise in: implementing persuasive technology for adherence and behavior change (Lyles), user-centered design, development, and evaluation with adolescents (Ozer), human-computer interaction and gamification (Gazzaley), ecological skills assessment (Lindhiem), adaptive intervention designs with digital tools (Murphy), and mechanisms underlying interventions (Pfiffner; HALP Director, primary mentor). Applying this training, the proposed research will use an iterative stakeholder-centered design to develop, refine, and preliminarily test a scalable digital health tool, applied as an adjunct to behavioral treatment for adolescents with ADHD (ages 11- 14). Following usability testing to guide refinements, a small pilot RCT (N=60) will examine target engagement and validation (skills utilization) for promoting enhanced and evaluate the feasibility of this novel tool when integrated with treatment delivery. The training, mentorship, and research supported by this K23 will facilitate the candidate in designing the next phase of this research, a large-scale adaptive intervention trial (R01) that delivers personalized strategies to optimize treatment engagement and skills utilization in real time.

项目摘要/摘要 而注意力缺陷/多动症的青少年基于证据的行为治疗 （ADHD）已经建立了良好 与随着时间的流逝消散的干预效果相关。当前的建议采用理论驱动的， 通过针对青少年的技能利用和 参与与ADHD相关障碍轨迹相关的其他可修改因素，包括奖励 敏感性，动力，执行功能和社会支持。移动技术提供变革性 参与这些目标并克服阻碍治疗的臭名昭著的挑战的机会 遵守多动症的青少年。该修订的K23奖将支持候选人开发 独立的研究职业调查创新方法，以优化青年的治疗反应 与多动症。该K23旨在提供必要的培训，以成为利用专家 技术增强资源以针对行为技能利用以增强治疗反应 并促进持续的改进。该奖项将为候选人提供高级培训：（1） 互动健康技术； （2）依从性促进； （3）生态学的方法和统计方法 有效的，实时评估和自适应干预设计； （4）基于机制的干预 改进和评估； （5）授予写作技巧和研究传播。通过大学 加利福尼亚，旧金山（USCF）多动症，注意力和学习问题（HALP）和 UCSF的临床和转化科学研究所（CTSI）奖，该候选人与 实现她的培训目标并完成这项研究的资源。 Mentalship团队包括高级 有积极的联邦资助研究，经验精神上的早期研究人员和 专业知识：实施有说服力的技术以依从性和行为改变（Lyles），以用户为中心 与青少年（Ozer），人类计算机互动和游戏化的设计，开发和评估 （Gazzaley），生态技能评估（Lindhiem），使用数字工具的自适应干预设计（Murphy）， 和基础干预措施的机制（PFFFNER； HALP主管，主要导师）。应用此培训， 拟议的研究将使用以迭代利益相关者为中心的设计来开发，完善和初步测试 可扩展的数字健康工具，作为ADHD青少年的行为治疗的辅助（11岁，年龄） 14）。经过可用性测试以指导完善，小型飞行员RCT（n = 60）将检查目标参与度 和验证（技能利用），以促进并评估这种新颖工具的可行性 与治疗输送结合。该K23支持的培训，精神训练和研究将有助于 设计这项研究的下一阶段的候选人是一项大规模的自适应干预试验（R01） 提供个性化策略，以实时优化治疗参与和技能利用。