Personalizing Behavioral Parent Training: Improving Reach and Outcomes for Families of Children with ADHD

个性化行为家长培训：提高多动症儿童家庭的影响力和成果

• 批准号: 10508840
• 负责人: Brittany Morgan Merrill
• 金额: $ 22.13万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10508840
• 关键词: Aftercare; American; Area; Attention deficit hyperactivity disorder; Attenuated; Behavioral; Businesses; Cellular Phone; Child; Child Behavior; Child Mental Health; Child Rearing; Childhood; Chronic; Clinic; Clinical; Clinical Trials; Communities; Control Groups; Data; Data Collection; Drops; Educational Intervention; Effectiveness; Effectiveness of Interventions; Evidence based treatment; Family; Feedback; Focus Groups; Guidelines; Health Benefit; Health system; Healthcare Systems; High Prevalence; Home; Human Resources; Impairment; Individual; Internet; Intervention; Interview; Low income; Measures; Mental Health; Mental Health Services; Mental disorders; Mind; Mobile Health Application; Occupational; Outcome; Parent-Child Relations; Parents; Performance; Prevalence; Protocols documentation; Public Health; Randomized; Reporting; Research; Stress; Supervision; Surveys; Technology; Testing; Time; Training; Travel; Treatment Effectiveness; Youth; acceptability and feasibility; adaptive intervention; arm; base; brief intervention; cost; design; effectiveness trial; experience; flexibility; improved; intervention refinement; mHealth; machine learning algorithm; personalized intervention; pilot trial; psychosocial; randomized trial; recruit; skills; smartphone Application; software development; standard care; success; therapy development; treatment research

PROJECT SUMMARY It is critical to improve the reach and efficacy of psychosocial treatments for childhood attention-deficit hyperactivity disorder (ADHD), the single most prevalent pediatric mental health disorder (9% prevalence; Danielson et al., 2018a). Evidence-based treatments for ADHD, such as behavioral parent training (BPT), produce moderate effect sizes on clinical outcomes including parenting skills, parent stress, child impairment, and child academic functioning when targeted (Evans et al., 2018; Merrill et al., 2017; Power et al., 2012). However, the impact of BPT in the community is attenuated by poor transportability and high therapist involvement in standard treatment. The magnitude of treatment need is far beyond the capacity of the current mental health system, with only about 30% of parents receiving BPT (Danielson et al., 2018b). Technology- delivered interventions, and specifically mHealth applications, can overcome this gap as 81% of Americans own a smartphone (Pew Research Center, 2019), and many minoritized and low-income individuals rely on smartphones for internet access. The current study aims to leverage an established data collection and intervention development smartphone application to develop and pilot a mobile BPT intervention for parents of children with ADHD and academic difficulties. The intervention will target candidate mechanisms of child behavioral and academic success including parenting skills, parent academic management, and engagement with treatment material. mBPT will include: 1) online, asynchronous treatment videos, 2) survey data collection, 3) prompts to complete between session parent practice, and 4) personalized adaptive components to enhance parenting skills. Following intervention development and refinement, 60 children with ADHD will be recruited from area pediatric practices and randomly assigned to (1) business and usual (BAU) or (2) mBPT. Within the mBPT group, adaptive components of the intervention will be evaluated in a microrandomized trial. Primary aims are to demonstrate the feasibility and acceptability of the intervention approach. Further, the hypothesized mechanisms (e.g., parent skill use, user engagement) will be measured and correspondence to hypothesized outcomes (e.g., improved child behavior and homework performance) will be evaluated. Data collected will be used to justify a larger effectiveness trial to evaluate mBPT effects on child behavior and academic impairment.

项目概要 提高儿童注意力缺陷心理社会治疗的覆盖范围和有效性至关重要 多动症 (ADHD)，一种最常见的儿科精神健康障碍（患病率 9%； 丹尼尔森等人，2018a)。 ADHD 的循证治疗，例如行为家长培训 (BPT)、 对临床结果产生中等程度的影响，包括养育技能、父母压力、儿童障碍、 以及儿童的学业功能（Evans 等，2018；Merrill 等，2017；Power 等，2012）。 然而，BPT 在社区中的影响因可运输性差和治疗师费用高而减弱 参与标准治疗。治疗需求的规模远远超出了目前的能力 心理健康系统，只有约 30% 的父母接受 BPT（Danielson 等人，2018b）。技术- 所提供的干预措施，特别是移动医疗应用程序，可以克服这一差距，因为 81% 的美国人 拥有智能手机（皮尤研究中心，2019），许多少数族裔和低收入个人依赖 用于访问互联网的智能手机。 当前的研究旨在利用现有的数据收集和干预措施的发展 为 ADHD 儿童的父母开发和试点移动 BPT 干预的智能手机应用程序 学业困难。干预措施将针对儿童行为和学业的候选机制 成功包括养育技巧、家长学业管理以及对治疗材料的参与。 mBPT 将包括：1）在线、异步治疗视频，2）调查数据收集，3）提示完成 会议家长实践，以及4）个性化的适应性组件，以提高育儿技能。 在制定和完善干预措施后，将从儿科地区招募 60 名多动症儿童 实践并随机分配至 (1) 商务和平常 (BAU) 或 (2) mBPT。在 mBPT 组中， 干预措施的适应性部分将在微观随机试验中进行评估。 主要目的是证明干预方法的可行性和可接受性。更远， 假设的机制（例如，家长技能使用、用户参与）将被测量并对应 将评估假设的结果（例如，儿童行为和家庭作业表现的改善）。数据 收集的数据将用于证明更大规模的有效性试验的合理性，以评估 mBPT 对儿童行为的影响 学业障碍。