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

项目摘要/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/ 多动障碍(ADHD)和对立违抗障碍(ODD)是最常见的 不同文化背景下的青少年心理健康状况。一种有效可行的改善受影响的方案 青少年ADHD/ODD正在培训现有的学校临床医生，以提供基于证据的干预措施。 尽管培训学校临床医生在患有高血压病的环境中治疗ADHD/ODD的初步结果令人振奋 未得到满足的需求，如墨西哥，可扩展性受到缺乏研究人员的培训、监测和 大规模评估学校临床医生在这方面的努力。因此，我们需要制定出更具可行性的 针对学校临床医生的干预和培训方案，以及创建一个有能力 可扩展的培训和评估，以应对ADHD/ODD在世界范围内的广泛影响。 将干预措施和学校临床医生专业发展计划转换为完全远程 交付可实现更高的灵活性、可访问性、经济实惠、可扩展性和持续承诺 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 墨西哥的重大公共卫生问题，因为只有14%的患有精神健康障碍的墨西哥青年 在接受治疗的患者中，只有不到一半的人得到了最低限度的适当护理。我们的团队是 非常适合这项工作，因为我们开发了唯一已知的学校家庭ADHD/ODD 拉丁美洲的循证干预-并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。我们之前的研究和高水平的未满足的需求使 墨西哥是这项提议的理想地点；然而，经验教训可以用来扩大可扩展的学校 针对其他环境和/或其他疾病的循证干预的临床医生培训。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，并展示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，青少年将表现出改善的ADHD/ODD H3)来自3所学校的开放试验的观察/反馈将指导对远程计划的迭代更改 目的2)在墨西哥建立可扩展干预和培训计划的研究能力。我们预测： H4)该大学(UAS)将举办一门关于临床研究、远程干预和培训计划的课程 H5)学生将展示更好的循证实践技能，并展示作为培训者的能力 目的3)在8所学校组成的随机对照试验中，比较完全远程计划和照常护理计划。我们预测： H6)接受远程培训的学校临床医生将感到满意，并显示出改进的技能 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/坚持 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/ODY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