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

为墨西哥学校心理健康提供者采用基于网络的专业发展，为 ADHD 和 ODD 提供循证干预

• 批准号: 10461155
• 负责人: Lauren Marie Haack
• 金额: $ 18.32万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10461155
• 关键词: Address; Affect; Attention; Attention deficit hyperactivity disorder; Behavior; Behavior Therapy; Caring; Clinical; Clinical Research; Competence; Consultations; Development; Disease; E-learning; Effectiveness; Evaluation; Evidence based intervention; Evidence based practice; Family; Feedback; Future; Health Personnel; Health Services Accessibility; Home; Impairment; Impulse Control Disorders; Intervention; Language; Latin America; Learning; Location; Mental Health; Mental disorders; Methods; Mexican; Mexico; Monitor; Neurodevelopmental Disorder; Online Systems; Oppositional Defiant Disorder; Parents; Persons; Prevalence; Program Development; Protocols documentation; Public Health; Randomized Controlled Trials; Research; Research Personnel; Resources; Schools; Students; Symptoms; System; Technology; Telephone; Training; Training Programs; Universities; Update; Videoconferencing; Vulnerable Populations; Work; Youth; combat; cost; evidence base; flexibility; improved; inattention; intervention delivery; intervention program; meetings; novel; programs; remote delivery; remote intervention; skills; success; teacher; web-based intervention

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

项目概要/摘要 注意力不集中和破坏性行为的神经发育障碍，例如注意力缺陷/ 多动症 (ADHD) 和对立违抗性障碍 (ODD) 是最常见的疾病 跨文化的青少年心理健康状况。改善受影响情况的有效且可行的解决方案 青少年 ADHD/ODD 正在培训现有的学校临床医生，以保真地提供循证干预措施。 尽管培训学校临床医生在患有高风险的环境中治疗 ADHD/ODD 的初步结果令人鼓舞 未满足的需求，例如墨西哥，由于缺乏有能力进行培训、监测和评估的研究人员，可扩展性受到限制。 大规模评估学校临床医生的此类努力。因此，我们需要开发更多可行的 为学校临床医生提供干预措施和培训计划，并创建一个有能力的系统 可扩展的培训和评估，以应对 ADHD/ODD 在全球范围内的广泛影响。 将干预措施和学校临床医生专业发展计划转变为完全远程 交付提供了更大的灵活性、可访问性、可负担性、可扩展性以及持续的承诺 咨询而不是面对面的选择。支持学校临床医生的可扩展培训可以解决 墨西哥存在重大公共卫生问题，因为只有 14% 患有精神健康障碍的墨西哥青年接受了治疗 治疗，只有不到一半的治疗者得到了超过最低限度的充分护理。我们的团队是 鉴于我们开发了唯一已知的学校家庭 ADHD/ODD，因此非常适合这项工作 拉丁美洲的循证干预 - 并且 - 为美国开发了基于网络的培训 学校临床医生取得了有希望的初步结果。我们之前的研究和大量未满足的需求使得 墨西哥是该提案的理想地点；然而，吸取的经验教训可用于扩大可扩展的学校规模 临床医生在其他环境和/或其他疾病中进行循证干预培训。因此，我们将： 目标 1) 对完全远程程序进行公开试用并进行迭代更改。我们预测： H1) 接受过远程培训的学校临床医生将会感到满意，并表现出改进的循证实践技能 H2) 远程参与的家庭和老师会感到满意，青少年的 ADHD/ODD 会得到改善 H3) 来自 3 所学校的开放试验的观察/反馈将指导远程项目的迭代变更 目标 2) 建设墨西哥的研究能力，以实施可扩展的干预和培训计划。我们预测： H4) 大学（UAS）将举办临床研究、远程干预和培训项目课程 H5) 学生将表现出改进的基于证据的实践技能并展示作为培训师的能力 目标 3) 在 8 所学校集群随机对照试验中比较完全远程计划与照常护理。我们预测： H6) 接受过远程计划培训的学校临床医生将会感到满意并表现出更高的技能 H7) 在远程计划中接受学校临床医生治疗的家长、青少年和教师将参与/遵守 H8) 与照常护理相比，远程计划中的青少年将表现出更多的 ADHD/ODD 改善