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

项目总结/摘要 青少年注意缺陷多动障碍的循证行为治疗 注意力缺陷多动障碍（ADHD）是公认的，这些干预措施往往不能在整个环境中推广， 随着时间的推移而消散的干预效应。目前的建议需要一个理论驱动的， 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变因素，包括奖励 敏感性、动机、执行功能和社会支持。移动的技术提供了变革性的 参与这些目标和克服阻碍治疗的众所周知的挑战的机会 对ADHD青少年的依从性。这个指导K23奖将支持候选人在发展， 独立的研究生涯，调查优化青年治疗反应的创新方法 注意力缺陷多动症此K23旨在提供必要的培训，使您成为利用 技术强化资源，以针对行为技能的利用，以增强治疗反应 促进持续改进。该奖项将为候选人提供以下方面的高级培训：（1） 交互式卫生技术;（2）坚持促进;（3）生态方法和统计方法 有效的、真实的时间评估和适应性干预设计;（4）基于机制的干预 改进和评估;（5）资助写作技巧和研究传播。通过大学的 加州，旧金山弗朗西斯科（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转化科学研究所（CTSI）奖，候选人是唯一配备 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 具有积极的联邦资助研究的调查员，指导早期职业调查员的经验， 专长：实施说服性技术以促进遵守和行为改变（莱尔斯），以用户为中心 与青少年一起设计、开发和评估（Ozer），人机交互和游戏化 （Gazzaley）、生态技能评估（Lindhiem）、采用数字化工具的适应性干预设计（Murphy）、 和干预机制（Pfiffner; HALP主任，主要导师）。通过这次培训， 拟议中的研究将使用一种迭代的、以持有者为中心的设计来开发、改进和初步测试一种 可扩展的数字健康工具，作为ADHD青少年（11岁- 14）。在指导改进的可用性测试之后，一项小型试点RCT（N = 60）将检查目标参与度 和验证（技能利用），以促进增强和评估这种新工具的可行性， 与治疗实施相结合。K23支持的培训、指导和研究将促进 设计本研究下一阶段的候选人，一个大规模的适应性干预试验（R01）， 提供个性化策略，以真实的实时优化治疗参与和技能利用。

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.