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

项目总结 提高儿童注意缺陷心理社会治疗的可及性和有效性至关重要。 多动症(ADHD)，最常见的一种儿科心理健康障碍(患病率为9%； Danielson等人，2018a)。对ADHD的循证治疗，如行为父母培训(BPT)， 对临床结果产生中等程度的影响，包括父母养育技能、父母压力、儿童损害、 和儿童的学习功能(Evans等人，2018年；Merrill等人，2017年；Power等人，2012年)。 然而，BPT在社区中的影响因便携性差和治疗师高而减弱 参与标准治疗。治疗需求的大小远远超出了目前的能力 心理健康系统，只有大约30%的父母接受BPT(Danielson等人，2018b)。技术-- 提供的干预措施，特别是移动健康应用程序，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)，许多小众化和低收入个人依赖于 用于互联网接入的智能手机。 目前的研究旨在利用已建立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BPT干预 学业上的困难。干预将针对儿童行为和学习的候选机制 成功包括为人父母的技巧、家长的学术管理和对治疗材料的投入。 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 在会话父母实践之间，和4)个性化的适应组件，以提高育儿技能。 经过干预的发展和完善，将从儿科地区招募60名ADHD儿童 实践，并随机分配到(1)业务和日常(BAU)或(2)mBPT。在mBPT组内， 干预措施的适应性部分将在微随机试验中进行评估。 主要目的是证明干预方法的可行性和可接受性。此外， 将对假设的机制(例如，父母技能使用、用户参与度)进行测量和对应 将对假设的结果(例如，改善的儿童行为和家庭作业表现)进行评估。数据 收集的数据将被用于证明一项更大的有效性试验的合理性，以评估mBPT对儿童行为的影响，并 学习障碍。

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.