2/2 Treating Mothers with ADHD and their Young Children Via Telehealth: A Hybrid Type I Effectiveness-Implementation Trial

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: 9806227
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 74.33万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9806227
• 关键词: Adoption; Adult; Attention; Attention deficit hyperactivity disorder; Awareness; Behavior Therapy; Behavioral; Caring; Child; Child Behavior; Child Rearing; Childhood; Clinical; Combined Modality Therapy; Data; Development; Early Intervention; Effectiveness; Enrollment; Environmental Risk Factor; Familial disease; Family; Genetic Risk; Health Personnel; Healthcare; Hybrids; Impairment; Impulsivity; Intervention; Left; Link; Literature; Mediating; Mental Health; Modeling; Mothers; Outcome; Parents; Participant; Patients; Pharmaceutical Preparations; Prevalence; Primary Health Care; Prior Therapy; Procedures; Provider; Randomized; Readiness; Recommendation; Research; Research Methodology; Risk; School-Age Population; Severities; Site; Structure; Symptoms; Tern; Testing; Time; Training; Treatment outcome; Washington; base; care delivery; care providers; comparative effectiveness; emotion dysregulation; emotion regulation; health care delivery; implementation trial; improved; inattention; innovation; medical specialties; offspring; personalized intervention; practice setting; primary care setting; primary outcome; racial and ethnic; racial diversity; recruit; screening participation; skills; socioeconomics; symptomatology; telehealth; treatment guidelines; treatment response; treatment strategy; uptake

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.

摘要/项目摘要 母体多动症，有25-50％的ADHD儿童家庭，经常未经治疗，会干扰 有效的育儿并预测儿童的发育和行为治疗结果不佳。基于 文学和我们自己的飞行员数据，我们将随机分配多动症的母亲及其年轻的处于危险的孩子 在两个条件之一中：（1）患有多动症的母亲，然后是儿童治疗策略 （CTS）从行为父母培训（BPT）开始，并增加了儿童兴奋剂的建议 治疗如果孩子仍然受到损害或（2）未治疗父母，儿童和 家庭成果。我们将检查目标机制，包括改善母体ADHD相关的 障碍和症状学（注意力，冲动，情绪调节），育儿技能和BPT 参与和治疗主持人（基线母体ADHD严重程度，孕产妇障碍和 育儿技能）。此外，为了开发具有广泛潜力的治疗模型 传播的同时还减少了接受护理的障碍，我们将筛选母亲在初级保健中的多动症， 在最常识别和治疗儿童多动症的地方，共同确定的心理健康提供者将提供 通过远程医疗治疗。使用利益相关者制定实施计划和相关工具包 参与策略将增强有效采用这种方法的能力。另外，我们 将研究护理交付环境，评估筛查和参与的程序和速度 作为人员配备，工作流程，提供者和患者级的可接受性，准备就绪和实施可行性 方法。这个混合有效性实施项目将通过2个协作R01实现 美国的研究站点（n = 240个家庭），每个站点有4-5个初级保健伙伴。