2/2 Treating Mothers with ADHD and their Young Children Via Telehealth: A Hybrid Type I Effectiveness-Implementation Trial

2/2 通过远程医疗治疗患有多动症的母亲及其幼儿：I 型有效性实施混合试验

• 批准号: 10410008
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 10.93万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10410008
• 关键词: Adoption; Adult; Attention; Attention deficit hyperactivity disorder; Awareness; Behavior Therapy; Behavioral; Caring; Child; Child Behavior; Child Rearing; Childhood; Clinical; Combined Modality Therapy; Data; Development; Dissemination and Implementation; Early Intervention; Enrollment; Environmental Risk Factor; Familial disease; Family; Genetic Risk; Health Personnel; Healthcare; Hybrids; Impairment; Impulsivity; Intervention; Left; Link; Literature; Mediating; Mental Health; Modeling; Mothers; Outcome; Parents; Participant; Patients; Pharmaceutical Preparations; Prevalence; Primary Health Care; Prior Therapy; Procedures; Provider; Randomized; Readiness; Recommendation; Research; Research Methodology; Risk; School-Age Population; Severities; Site; Structure; Symptoms; Testing; Time; Training; Treatment outcome; Washington; base; care delivery; care providers; comparative effectiveness; effectiveness implementation study; effectiveness implementation trial; emotion dysregulation; emotion regulation; health care delivery; implementation barriers; implementation study; improved; inattention; innovation; maternal outcome; medical specialties; offspring; personalized intervention; practice setting; prescription stimulants; primary care setting; primary outcome; racial and ethnic; racial diversity; recruit; screening participation; skills; socioeconomics; symptomatology; telehealth; treatment guidelines; treatment response; treatment strategy; uptake

ABSTRACT/PROJECT SUMMARY Maternal ADHD, present in 25-50% of families of children with ADHD and frequently untreated, interferes with effective parenting and predicts poor child developmental and behavioral treatment outcomes. Based on the literature and our own pilot data, we will randomly assign mothers with ADHD and their young at-risk children to one of two conditions: (1) stimulant medication for mothers with ADHD followed by a child treatment strategy (CTS) beginning with behavioral parent training (BPT) with the added recommendation of child stimulant treatment if the child remains impaired or (2) a CTS without treatment for maternal ADHD on parent, child, and family outcomes. We will examine target mechanisms including improvements in maternal ADHD-related impairment and symptomatology (attention, impulsivity, emotional regulation), parenting skills, and BPT engagement, as well as treatment moderators (baseline maternal ADHD severity, maternal impairment, and parenting skills). Moreover, in an effort to develop a model of treatment that has potential for widespread dissemination while also reducing barriers to receiving care, we will screen mothers for ADHD in primary care, where child ADHD is most often identified and treated, and co-located mental health providers will deliver treatments via telehealth. Development of an implementation plan and associated toolkit using a stakeholder participatory strategy will enhance the ability to move efficiently to adoption of this approach. In addition, we will study the care delivery context, assessing procedures for and rates of screening and participation as well as staffing, workflow, provider- and patient-level acceptability, readiness, and feasibility of implementation approaches. This hybrid effectiveness-implementation project will be achieved via a collaborative R01 across 2 research sites in the US (N = 240 families), with 4-5 primary care partners at each site.

抽象/项目总结