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）：当前的研究建议使用随机控制的设计来测试有氧运动对患有注意力缺陷多动症（ADHD）和破坏性行为障碍（DBD）（DBD）的可行性和影响。流行病学研究估计，多动症的社区流行率在8％至23％之间，DBD在5％至9％之间。这些疾病的合并很高，据报道，在非洲裔美国人和城市贫困社区中，有可能满足需求的资源受到严重限制的比率近三倍。如果未经治疗，患有多动症和DBD的儿童可能会在多个领域遭受长期损害。基于循证的ADHD和DBD干预措施是心理药理和心理社会的。尽管两者都是有效的，但有些孩子对药物的反应不反应或经历不良的副作用，而心理社会治疗需要大量的时间和资源。学校提供70-80％的社会心理服务，而低收入学校的不幸现实是，资源有限，条件恶化，高人员压力和改善标准化考试成绩的压力使与心理健康咨询和计划实施相关的时间和资源投资尤其挑战。因此，城市贫困社区的服务利用率极低。这项研究以大量文献为基础，表明多动症的特征是EF发展的损害。有氧活动不成比例地影响EF过程及其支持它们的大脑区域。这一证据加上对改善日常运作的儿童ADHD和DBD开发基于证据的干预措施的巨大需求，这些干预措施提高了日常运作，是低成本，并且具有广泛的传播潜力，这表明有氧活动值得调查作为城市贫困社区ADHD和DBD的广泛治疗和管理的潜在工具。拟议的研究将使患有多动症和/或DBD的儿童随机进行Project Play，这是一项基于证据的12周后课后有氧运动干预措施，该干预措施旨在改善超重非破坏性儿童或注意力控制条件的EF。它的目的是（1）通过出勤记录，保留率和心率监测来测试针对高贫困社区中ADHD和DBD儿童的项目游戏的可行性； （2）检查有氧活动的EF益处是否通过执行功能和神经心理学任务的行为评级清单适用于患有多动症和DBD的儿童； （3）确定干预措施通过教师报告，父母报告，直接观察和基于课程的措施影响儿童的行为和学习成绩的程度。当前的研究将启动一项研究计划，研究身体活动干预措施，这是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：当前的研究对低成本可访问的基于循证的干预措施的需求做出了反应，这些干预措施改善了注意力缺陷多动障碍（ADHD）和破坏性行为障碍（DBD）的日常功能。该研究承认大量证据表明，有氧活性使ADHD构成的认知系统受益，并与DBD相关。并建议测试有氧活动干预对生活在城市贫困社区中的ADHD和DBD儿童的认知，行为和学术功能的影响。