Personalizing Behavioral Parent Training: Improving Reach and Outcomes for Families of Children with ADHD

项目摘要 关键是要提高儿童注意力缺陷的心理社会治疗的覆盖面和有效性 多动症（ADHD）是最常见的儿童心理健康障碍（患病率为9%; Danielson等人，2018年a）。ADHD的循证治疗，如行为父母培训（BPT）， 对临床结果产生中等影响，包括育儿技能，父母压力，儿童损伤， 和儿童学术功能（Evans等人，2018;梅里尔等人，2017; Power等人，2012年）。 然而，BPT在社区中的影响因可移植性差和治疗师高 参与标准治疗。治疗需求的规模远远超出了目前的能力， 精神卫生系统，只有约30%的父母接受BPT（Danielson等人，2018年b）。技术- 提供的干预措施，特别是mHealth应用程序，可以克服这一差距，因为81%的美国人 拥有智能手机（皮尤研究中心，2019年），许多少数民族和低收入个人依赖于 智能手机上网。 目前的研究旨在利用既定的数据收集和干预发展 智能手机应用程序，为ADHD儿童的父母开发和试点移动的BPT干预， 学术困难。干预将针对儿童行为和学业的候选机制 成功，包括育儿技巧，父母的学术管理和参与治疗材料。 mBPT将包括：1）在线，异步治疗视频，2）调查数据收集，3）提示完成 4）个性化的适应性组件，以提高育儿技能。 在开发和完善干预措施后，将从地区儿科招募60名ADHD儿童， 实践，并随机分配到（1）业务和通常（BAU）或（2）mBPT。在mBPT组中， 将在微观随机试验中评估干预措施的适应性组成部分。 主要目的是证明干预方法的可行性和可接受性。此外，本发明还 假设的机制（例如，父母技能使用，用户参与）将被衡量和通信 假设的结果（例如，改善儿童行为和家庭作业表现）。数据 收集的数据将用于证明更大规模的有效性试验，以评估mBPT对儿童行为的影响， 学业障碍

PROJECT SUMMARY It is critical to improve the reach and efficacy of psychosocial treatments for childhood attention-deficit hyperactivity disorder (ADHD), the single most prevalent pediatric mental health disorder (9% prevalence; Danielson et al., 2018a). Evidence-based treatments for ADHD, such as behavioral parent training (BPT), produce moderate effect sizes on clinical outcomes including parenting skills, parent stress, child impairment, and child academic functioning when targeted (Evans et al., 2018; Merrill et al., 2017; Power et al., 2012). However, the impact of BPT in the community is attenuated by poor transportability and high therapist involvement in standard treatment. The magnitude of treatment need is far beyond the capacity of the current mental health system, with only about 30% of parents receiving BPT (Danielson et al., 2018b). Technology- delivered interventions, and specifically mHealth applications, can overcome this gap as 81% of Americans own a smartphone (Pew Research Center, 2019), and many minoritized and low-income individuals rely on smartphones for internet access. The current study aims to leverage an established data collection and intervention development smartphone application to develop and pilot a mobile BPT intervention for parents of children with ADHD and academic difficulties. The intervention will target candidate mechanisms of child behavioral and academic success including parenting skills, parent academic management, and engagement with treatment material. mBPT will include: 1) online, asynchronous treatment videos, 2) survey data collection, 3) prompts to complete between session parent practice, and 4) personalized adaptive components to enhance parenting skills. Following intervention development and refinement, 60 children with ADHD will be recruited from area pediatric practices and randomly assigned to (1) business and usual (BAU) or (2) mBPT. Within the mBPT group, adaptive components of the intervention will be evaluated in a microrandomized trial. Primary aims are to demonstrate the feasibility and acceptability of the intervention approach. Further, the hypothesized mechanisms (e.g., parent skill use, user engagement) will be measured and correspondence to hypothesized outcomes (e.g., improved child behavior and homework performance) will be evaluated. Data collected will be used to justify a larger effectiveness trial to evaluate mBPT effects on child behavior and academic impairment.