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: 10301492
• 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 2024-11-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10301492
• 关键词: Address; Adherence; Adolescent; Adult; Affect; Aftercare; Age; Alcohol or Other Drugs use; Attention; Attention deficit hyperactivity disorder; Award; Behavior Therapy; Behavioral; California; Caring; Childhood; Clinical Sciences; Clinical Trials; Data; Development; Development Plans; Effectiveness; Enhancement Technology; Evaluation; Family; Feedback; Financial Hardship; Focus Groups; Funding; Future; Goals; Grant; Health; Health Personnel; Health Technology; Hyperactive behavior; Impairment; Institutes; 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; Research; Research Personnel; Research Support; Resources; Rewards; Risk; San Francisco; Schools; Severities; Short-Term Memory; Social support; Strategic Planning; Student Dropouts; System; Technology; Testing; Time; Training; Transferable Skills; Translational Research; Treatment outcome; Universities; Validation; Work; Writing; Youth; adaptive intervention; base; behavior change; career; career development; cognitive process; cognitive system; computer human interaction; contingency management; cost; design; digital; effectiveness trial; evidence base; executive function; experience; follow-up; forgetting; functional disability; improved; in vivo; innovation; interactive tool; intervention effect; mobile computing; novel; personalized strategies; programs; reduce symptoms; research data dissemination; response; reward processing; skills; social; 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 注意缺陷/多动障碍青少年的循证行为治疗 多动症(ADHD)是公认的，但这些干预措施往往无法在各种情况下推广，而且 与随时间消散的干预效应有关。目前的提案采取了一种理论驱动的、 以青少年技能利用为目标优化现有行为治疗的实证方法 使用与ADHD相关损害的轨迹相关的其他可修改因素，包括奖励 敏感度、动力、执行功能和社会支持。移动技术提供变革性的 利用这些目标和克服阻碍治疗的臭名昭著的挑战的机会 ADHD青少年的坚持。这项指导K23奖将支持候选人制定 独立研究生涯，研究优化青年治疗反应的创新方法 患有多动症。K23旨在提供必要的培训，使其成为杠杆方面的专家 针对行为技能利用的技术增强型资源，以提高治疗反应 并促进持续改善。该奖项将为候选人提供以下方面的高级培训：(1) 互动卫生技术；(2)坚持促进；(3)生态的方法和统计途径 有效的实时评估和适应性干预设计；以及(4)基于机制的干预 改进和评估；以及(5)授予写作技能和研究传播。通过伊利诺伊大学 加州旧金山(USCF)多动、注意力和学习问题实验室(HALP)和 加州大学旧金山分校的临床和翻译科学研究所(CTSI)奖，候选人独特地配备了 资源，以实现她的培训目标，并完成这项研究。导师团队包括资深学生 拥有积极的联邦资助研究的级别调查人员，有指导早期职业调查人员的经验，以及 专业知识：实施以用户为中心的说服性技术以实现遵从性和行为改变(莱尔斯) 青少年设计、开发和评估(OZER)、人机交互和游戏化 (Gazzaley)、生态技能评估(Lindhiem)、数字工具适应性干预设计(Murphy)、 和干预措施背后的机制(Pfiffner；HALP董事，主要导师)。应用这一培训， 建议的研究将使用以利益相关者为中心的迭代设计来开发、改进和初步测试 可扩展的数字健康工具，作为ADHD青少年行为治疗的辅助工具(11岁- 14)。在进行可用性测试以指导改进之后，一个小型试点RCT(N=60)将检查目标参与度 和验证(技能利用率)以促进增强，并在以下情况下评估此新工具的可行性 与治疗服务相结合。由该K23支持的培训、指导和研究将促进 设计该研究下一阶段的候选者是一项大规模适应性干预试验(R01)， 提供个性化策略，以实时优化治疗参与度和技能利用率。