Physical Activity Intervention for ADHD and DBD

ADHD 和 DBD 的身体活动干预

• 批准号: 8206421
• 负责人: Eduardo Esteban Bustamante
• 金额: $ 3.91万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-08-29 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8206421
• 关键词: 12 year old; Adverse effects; Aerobic; Aerobic Exercise; African; African American; Age; Area; Attention; Attention deficit hyperactivity disorder; Behavior; Behavioral; Brain; Characteristics; Child; Child Behavior; Childhood; Clinic; Cognitive; Communities; Consultations; Coupled; Development; Disease; Disruptive Behavior Disorder; Educational Curriculum; Epidemiologic Studies; Equipment and supply inventories; Evidence based intervention; Evidence based treatment; Family; Focus Groups; Gender; Heart Rate; Hyperactive behavior; Impairment; Individual; Intervention; Investigation; Investments; Life; Literature; Low income; Maximum Heart Rate; Measures; Mental Health; Mental health promotion; Monitor; Outcome Measure; Overweight; Parents; Performance; Pharmaceutical Preparations; Physical Fitness; Physical activity; Play; Poverty; Prevalence; Problem Solving; Process; Psychiatric Social Work; Randomized; Randomized Controlled Trials; Reading; Records; Relative (related person); Reporting; Research; Resources; Sampling; Schools; Severities; Short-Term Memory; Stress; Symptoms; Testing; Time; base; cognitive system; cost; daily functioning; design; evidence base; executive function; experience; fitness; improved; meetings; neuropsychological; post intervention; pressure; primary outcome; programs; psychopharmacologic; psychosocial; satisfaction; service utilization; teacher; tool; vigilance

DESCRIPTION (provided by applicant): The current study proposes to use a randomized controlled design to test the feasibility and impact of aerobic physical activity for children with Attention Deficit Hyperactivity (ADHD) and Disruptive Behavior Disorders (DBD) living in an urban poor community. Epidemiological studies estimate the community prevalence of ADHD to be between 8 and 23%, and DBD to be between 5% and 9%. The disorders are highly comorbid and rates are reported to be nearly three times higher among African American and urban poor communities where the resources available to meet the need are severely limited. If untreated, children with ADHD and DBD are likely to suffer long-term impairments across multiple domains. Evidence-based interventions for ADHD and DBD are psychopharmacological and psychosocial. Though both are effective, some children are unresponsive to or experience unwanted side effects from medications, and psychosocial treatments require considerable time and resources. Schools provide 70-80% of psychosocial services and the unfortunate reality in low-income schools is that limited resources, deteriorating conditions, high staff stress, and pressure to improve standardized test scores make the time and resource investments associated with mental health consultation and program implementation especially challenging. Consequently, rates of service utilization are extremely low in urban poor communities. This study builds on a sizeable literature demonstrating that ADHD is characterized by, and DBD has been associated with, impairments in the development of EF; and that aerobic activity disproportionately influences EF processes and the brain areas that support them. This evidence, coupled with the great need for development of evidence-based interventions for childhood ADHD and DBD that improve daily functioning, are low cost, and have potential for broad dissemination suggests that aerobic activity warrants investigation as a potential tool in the broad treatment and management of ADHD and DBD in urban poor communities. The proposed study will randomize children with ADHD and/or DBD to Project Play, an evidence-based 12-week after-school aerobic activity intervention demonstrated to improve EF in overweight non-disruptive children, or an attention control condition. It aims to (1) test the feasibility of Project Play for children with ADHD and DBD living in a high poverty community via attendance records, retention rates, and Heart Rate Monitoring; (2) examine whether the EF benefits of aerobic activity apply to children with ADHD and DBD via the Behavioral Rating Inventory of Executive Function and neuropsychological tasks; and (3) determine the extent to which the intervention influences children's behavior and academic performance via teacher-report, parent-report, direct observation, and curriculum-based measures. The current study will launch a program of research examining physical activity interventions as one component of coordinated mental health promotion efforts in urban poor communities. PUBLIC HEALTH RELEVANCE: The current study responds to the need for low-cost widely-accessible evidence-based interventions that improve daily functioning in children with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders (DBD). The study acknowledges a large body of evidence suggesting that aerobic activity benefits the same cognitive systems that underlie ADHD, and have been associated with DBD; and proposes to test the impact of an aerobic activity intervention on cognitive, behavioral, and academic functioning in children with ADHD and DBD living in an urban poor community.

描述（由申请人提供）：本研究建议使用随机对照设计来测试有氧体育活动对生活在城市贫困社区的注意力缺陷多动症（ADHD）和破坏性行为障碍（DBD）儿童的可行性和影响。流行病学研究估计 ADHD 的社区患病率在 8% 到 23% 之间，DBD 的患病率在 5% 到 9% 之间。这些疾病具有高度共病性，据报道，非洲裔美国人和城市贫困社区的发病率几乎高出三倍，而这些社区可用于满足需求的资源严重有限。如果不及时治疗，患有 ADHD 和 DBD 的儿童可能会在多个领域遭受长期损害。 ADHD 和 DBD 的循证干预措施包括精神药理学和心理社会干预措施。尽管两者都有效，但有些儿童对药物没有反应或出现不良副作用，而心理社会治疗需要大量时间和资源。学校提供 70-80% 的心理社会服务，而低收入学校的不幸现实是，资源有限、条件恶化、员工压力大以及提高标准化考试成绩的压力，使得与心理健康咨询和项目相关的时间和资源投资实施尤其具有挑战性。因此，城市贫困社区的服务利用率极低。这项研究建立在大量文献的基础上，证明 ADHD 的特点是 EF 发展受损，而 DBD 与 EF 发展受损有关。有氧活动不成比例地影响 EF 过程和支持它们的大脑区域。这一证据，加上对儿童 ADHD 和 DBD 开发基于证据的干预措施的巨大需求，这些干预措施可改善日常功能，成本低廉，并具有广泛传播的潜力，表明有氧活动值得研究，作为广泛治疗和治疗的潜在工具。城市贫困社区 ADHD 和 DBD 的管理。拟议的研究将把患有 ADHD 和/或 DBD 的儿童随机分配到 Project Play 中，这是一种基于证据的 12 周课后有氧活动干预措施，被证明可以改善超重的无干扰儿童的 EF 或注意力控制条件。其目的是 (1) 通过出勤记录、保留率和心率监测来测试针对生活在高度贫困社区的 ADHD 和 DBD 儿童的项目游戏的可行性； (2) 通过执行功能和神经心理学任务的行为评定量表，检查有氧活动的 EF 益处是否适用于 ADHD 和 DBD 儿童； (3) 通过教师报告、家长报告、直接观察和基于课程的措施确定干预措施对儿童行为和学业成绩的影响程度。目前的研究将启动一项研究计划，检查身体活动干预措施，作为城市贫困社区协调心理健康促进工作的一部分。 公共卫生相关性：当前的研究满足了对低成本、广泛可及的循证干预措施的需求，这些干预措施可改善患有注意力缺陷多动障碍 (ADHD) 和破坏性行为障碍 (DBD) 的儿童的日常功能。该研究承认大量证据表明有氧运动有益于 ADHD 的相同认知系统，并且与 DBD 相关。并提议测试有氧活动干预对生活在城市贫困社区的 ADHD 和 DBD 儿童的认知、行为和学业功能的影响。