2/2 通过远程医疗治疗患有多动症的母亲及其幼儿：I 型有效性实施混合试验-猫眼课题宝

2/2 通过远程医疗治疗患有多动症的母亲及其幼儿：I 型有效性实施混合试验

批准号：

10664862

负责人：

ANDREA CHRONIS-TUSCANO

金额：

$59.01万

依托单位：

UNIV OF MARYLAND, COLLEGE PARK

依托单位国家：

美国

项目类别：

财政年份：

2019

资助国家：

美国

项目状态：

已结题

起止时间：

2019-08-15 至 2024-07-31

来源：

https://reporter.nih.gov/project-details/10664862

关键词：

Adoption Adult Affect Attention Attention deficit hyperactivity disorder Awareness Behavior Therapy Behavioral Caring Child Child Behavior Child Rearing Child of Impaired Parents Childhood Clinical Combined Modality Therapy Data Development Dissemination and Implementation Early Intervention Enrollment Environmental Risk Factor Ethnic Origin Familial disease Family Genetic Risk Health Personnel Hybrids Impairment Impulsivity Intervention Left Link Literature Mediating Mental Health Mental Health Services Modeling Mothers Organization administrative structures Outcome Parents Participant Patients Pharmaceutical Preparations Prevalence Primary Care Prior Therapy Procedures Provider Randomized Readiness Recommendation Research Research Methodology Risk School-Age Population Severities Site Stimulant Symptoms Testing Time Training Treatment outcome Washington care delivery comparative effectiveness effectiveness/implementation hybrid effectiveness/implementation trial emotion dysregulation emotion regulation health care delivery implementation barriers implementation study improved inattention innovation maternal outcome medical specialties offspring personalized intervention practice setting prescription stimulants primary care practice primary care provider primary care setting primary outcome racial diversity recruit screening skills socioeconomics symptomatology telehealth treatment guidelines treatment response treatment strategy uptake

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ABSTRACT/PROJECT SUMMARY Maternal ADHD, present in 25-50% of families of children with ADHD and frequently untreated, interferes with effective parenting and predicts poor child developmental and behavioral treatment outcomes. Based on the literature and our own pilot data, we will randomly assign mothers with ADHD and their young at-risk children to one of two conditions: (1) stimulant medication for mothers with ADHD followed by a child treatment strategy (CTS) beginning with behavioral parent training (BPT) with the added recommendation of child stimulant treatment if the child remains impaired or (2) a CTS without treatment for maternal ADHD on parent, child, and family outcomes. We will examine target mechanisms including improvements in maternal ADHD-related impairment and symptomatology (attention, impulsivity, emotional regulation), parenting skills, and BPT engagement, as well as treatment moderators (baseline maternal ADHD severity, maternal impairment, and parenting skills). Moreover, in an effort to develop a model of treatment that has potential for widespread dissemination while also reducing barriers to receiving care, we will screen mothers for ADHD in primary care, where child ADHD is most often identified and treated, and co-located mental health providers will deliver treatments via telehealth. Development of an implementation plan and associated toolkit using a stakeholder participatory strategy will enhance the ability to move efficiently to adoption of this approach. In addition, we will study the care delivery context, assessing procedures for and rates of screening and participation as well as staffing, workflow, provider- and patient-level acceptability, readiness, and feasibility of implementation approaches. This hybrid effectiveness-implementation project will be achieved via a collaborative R01 across 2 research sites in the US (N = 240 families), with 4-5 primary care partners at each site.

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