Iteratively developing and testing a brief, engagement focused intervention for parents and educators: Parent Education Action Response (PEAR)

反复开发和测试针对家长和教育工作者的简短的、以参与为重点的干预措施：家长教育行动响应 (PEAR)

• 批准号: 10739083
• 负责人: Courtney Anne Zulauf-McCurdy
• 金额: $ 15.51万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10739083
• 关键词: 6 year old; Address; Attention deficit hyperactivity disorder; Behavior Therapy; Child; Childhood; Development; Disparity; Early Intervention; Early treatment; Frequencies; Future; Goals; Intervention; Learning; Measurement; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Minority; Modeling; National Institute of Mental Health; Nursery Schools; Outcome; Parenting Education; Parents; Phase; Prevention; Program Development; Randomized, Controlled Trials; Recommendation; Research; Research Personnel; Statistical Models; Strategic Planning; Symptoms; Testing; Training; acceptability and feasibility; aged; behavioral adherence; behavioral health; behavioral response; brief intervention; comparison intervention; design; disparity reduction; effective therapy; experience; health disparity; improved; improved outcome; innovation; interest; iterative design; minority children; prevent; prototype; response; service delivery; social determinants; teacher; therapy development; treatment comparison

PROJECT SUMMARY Symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) emerge as early as preschool and are highly persistent throughout childhood. Early and effective treatment can blunt the typical developmental progression seen with ADHD. Despite the importance of early intervention, historically minoritized children are less likely to be identified as needing supports, and less likely to receive appropriate treatment compared to white children. This disproportionately in service delivery may place some children on negative long-term behavioral health trajectories. To reduce this dramatic disparity in ADHD that is strongly associated with the trajectory of a child’s future, it is critical that we identify malleable factors associated with eliminating ADHD disparities in preschool. For preschoolers who display elevated ADHD symptoms, behavioral interventions are recommended as the first line of treatment and are most effective when they target both parents and teachers. However, parents and teachers experience barriers to implementing behavioral interventions with the recommended frequency and fidelity with teachers frequently citing parents as barriers to adherence of behavioral interventions. In the current study, we propose that the relationship between parents and teachers is a determinant of ADHD outcomes by impacting the potency (and use) of behavioral interventions. Our overarching goal is to Discover, Design, and Test a brief intervention to improve parent and teacher engagement in behavioral interventions for preschoolers demonstrating elevated ADHD symptoms (Parent-Educator Action Response; PEAR). The project will be conducted in 3 phases: 1) discover barriers to engaging in behavioral interventions among parents and preschool educators as well as stakeholder-informed strategies to address these barriers through an Innovation Tournament (Aim 1), (2) iteratively design and build PEAR to address identified barriers from Aim 1 through a program development team and rapid prototyping (Aim 2), and (3) test the acceptability and feasibility of PEAR in small-scale randomized controlled trial of the PEAR + behavioral intervention compared to behavioral intervention only with 14 classrooms (42 parents and 14 educators of children aged 3-6 years old with elevated ADHD symptoms; Aim 3). This K23 reflects the Notices of Special Interest in Diversity (NOT-OD- 20-31), NIMH Strategic Plan Goal 3 (Strive for Prevention and Cures), and the NIMH call to prevent or forestall the emergence of ADHD in preschool (RFA-MH-21-230) by focusing on promoting parent and teacher engagement in behavioral interventions to improve implementation, ultimately improving outcomes for preschoolers from historically minoritized backgrounds with elevated ADHD symptoms. The research aims will also serve as vehicles for pragmatic learning of the following training goals: 1) culturally humility, 2) expertise in intervention development to reduce disparities, 3) advanced statistical modeling and measurement models for social determinants research. This mentored K23 award will facilitate Dr. Zulauf-McCurdy’s long-term goal of becoming an independent investigator with expertise in reducing mental health disparities in preschool.

项目摘要 注意力缺陷/多动障碍（ADHD）的症状早在学龄前就出现了， 在整个童年时期持续存在。早期和有效的治疗可以减缓典型的发展进程 注意力缺陷多动症尽管早期干预的重要性，历史上少数民族儿童不太可能 与白色儿童相比，这些儿童被认为需要支持，不太可能得到适当的治疗。 这种不成比例的服务提供可能会使一些儿童长期处于负面行为健康状态 轨迹为了减少多动症的这种巨大差异，这种差异与儿童的发展轨迹密切相关 在未来，我们确定与消除学龄前ADHD差异相关的可塑性因素至关重要。 对于表现出ADHD症状升高的学龄前儿童，建议进行行为干预， 这是第一线治疗，当他们针对家长和教师时最有效。然而，父母和 教师在按照建议的频率实施行为干预方面遇到障碍， 教师的忠诚经常引用父母作为行为干预坚持的障碍。在 目前的研究，我们提出，父母和教师之间的关系是一个决定因素，多动症 通过影响行为干预措施的效力（和使用）来影响结果。我们的首要目标是发现， 设计并测试一个简短的干预措施，以提高家长和教师在行为干预中的参与度， 表现出ADHD症状升高的学龄前儿童（家长-教育者行动反应; PEAR）。的 项目将分3个阶段进行：1）发现参与行为干预的障碍， 家长和学前教育工作者以及家长知情的战略，以解决这些障碍， 创新锦标赛（目标1），（2）迭代设计和构建PEAR，以解决已识别的障碍， 目标1通过程序开发团队和快速原型（目标2），以及（3）测试可接受性和 PEAR +行为干预的可行性小规模随机对照试验比较 对14个教室（42名3-6岁儿童的家长和14名教育工作者）进行行为干预 注意力缺陷多动障碍（ADHD）症状加重;目标3）。本K23反映了多样性特别关注通知（NOT-OD- 20-31），NIMH战略计划目标3（努力预防和治愈），以及NIMH呼吁预防或阻止 注意力缺陷多动障碍的出现在学前班（RFA-MH-21-230），重点是促进家长和教师 参与行为干预，以改善实施，最终改善结果， 来自历史上少数民族背景的学龄前儿童，ADHD症状加重。研究目的将 也作为以下培训目标的务实学习的工具：1）文化上的谦逊，2） 制定干预措施，以减少差距，3）先进的统计建模和测量模型， 社会决定因素研究。这个指导K23奖将促进Zulauf-McCurdy博士的长期目标， 成为一名独立的调查员，拥有减少学龄前儿童心理健康差异的专业知识。