Adapting a Web-Based Professional Development for Mexican School Mental Health Providers Delivering Evidence-Based Intervention for ADHD and ODD

项目总结/摘要 注意力不集中和破坏性行为的神经发育障碍，如注意力缺陷/ 多动症（ADHD）和对立违抗性障碍（ODD）是最常见的 不同文化的青年心理健康状况。一个有效可行的解决方案，以改善影响 青少年ADHD/ODD正在培训现有的学校临床医生，以忠实地提供基于证据的干预。 尽管培训学校临床医生在患有高血压的环境中治疗ADHD/ODD的初步结果很有希望， 未满足的需求，如墨西哥，可扩展性受到缺乏有能力培训，监测和 评估学校临床医生在这样的努力在大规模。因此，我们需要制定更可行的 学校临床医生的干预措施和培训计划，以及建立一个有能力 可扩展的培训和评估，以应对ADHD/ODD在全球的广泛影响。 转换干预措施和学校临床医生专业发展计划， 交付允许更大的灵活性、可访问性、可负担性、可扩展性和持续的承诺， 咨询比个人选择。支持学校临床医生的可扩展培训可以解决 这是墨西哥一个重大的公共卫生问题，因为只有14%的墨西哥青年精神健康障碍患者接受 在接受治疗的人中，只有不到一半的人得到最低限度的适当护理。我们的团队是 鉴于我们开发了唯一已知的学校-家庭ADHD/ODD， 在拉丁美洲的循证干预-和-已经开发了一个基于网络的培训，为美国 学校的临床医生有希望的初步结果。我们之前的研究和高水平的未满足需求使得 墨西哥是这一提议的理想地点;然而，吸取的经验教训可用于扩大可扩展的学校 对临床医生进行培训，以便在其他情况下和/或对其他疾病进行循证干预。因此，我们将： 目标1）对完全远程程序进行开放试验，并进行迭代更改。我们预测： H1）远程培训的学校临床医生将感到满意，并显示出改进的循证实践技能 H2）远程参与的家庭和教师将感到满意，青少年将表现出ADHD/ODD的改善 H3）来自3所学校开放试验的观察/反馈将指导远程程序的迭代更改 目标2）在墨西哥建立研究能力，以开展可扩展的干预和培训方案。我们预测： H4）大学（UAS）将举办临床研究，远程干预和培训课程 H5）学生将展示改进的循证实践技能，并展示作为培训师的能力 目标3）在一个8所学校的随机对照试验中比较完全远程方案与常规护理方案。我们预测： H6）接受远程培训的学校临床医生会感到满意，并表现出更高的技能 H7）家长、青少年和教师在远程项目中接受学校临床医生的治疗， H8）与常规护理相比，远程计划中的青少年将显示更多ADHD/ODD改善

Project Summary/Abstract Neurodevelopmental disorders of inattention and disruptive behavior, such as Attention-Deficit/ Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD), are among the most common youth mental health conditions across cultures. An efficacious and feasible solution to improving affected youth's ADHD/ODD is training existing school clinicians to deliver evidence-based intervention with fidelity. Despite initial promising results of training school clinicians to treat ADHD/ODD in settings suffering from high unmet need, such as Mexico, scalability is limited by a lack of researchers with capacity to train, monitor, and evaluate school clinicians in such efforts on a large scale. Thus, we need to develop more feasible interventions and training programs for school clinicians, as well as create a system with capacity for scalable training and evaluation, to combat the widespread impact of ADHD/ODD worldwide. Converting interventions and school clinician professional development programs for fully-remote delivery allows for more flexibility, accessibility, affordability, scalability, and promise for ongoing consultation than in-person options. Supporting scalable training for school clinicians could address a significant public health concern in Mexico, as only 14% of Mexican youth with mental health disorders receive treatment and less than half of those treated receive more than minimally adequate care. Our team is uniquely suited for this effort, given that we developed the only known school-home ADHD/ODD evidence-based intervention in Latin America -and- have developed a web-based training for U.S. school clinicians with promising preliminary results. Our prior studies and high levels of unmet need make Mexico an ideal location for this proposal; however, lessons learned could be used to expand scalable school clinician training for evidence-based intervention in other settings and/or for other disorders. Thus, we will: Aim 1) Conduct an open-trial of the fully-remote program and make iterative changes. We predict: H1) school clinicians trained remotely will be satisfied and show improved evidence-based practice skills H2) families and teachers participating remotely will be satisfied and youth will show improved ADHD/ODD H3) observation/feedback from a 3-school open-trial will guide iterative changes to the remote program Aim 2) Build research capacity in Mexico for scalable intervention and training programs. We predict: H4) the university (UAS) will host a course on clinical research, remote intervention and training programs H5) students will show improved evidence-based practice skills and demonstrate competency as trainers Aim 3) Compare the fully-remote program vs. care-as-usual in an 8-school clustered RCT. We predict: H6) school clinicians trained in the remote program will be satisfied and show improved skills H7) parents, youth, and teachers treated by school clinicians in the remote program will engage/adhere H8) youth in the remote program will show more ADHD/ODD improvements compared to care-as-usual