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.

项目概要 注意力缺陷/多动症 (ADHD) 的症状早在学龄前就出现，并且严重 贯穿整个童年。早期有效的治疗可以减缓典型的发育进程 患有多动症。尽管早期干预很重要，但历史上的少数民族儿童不太可能 与白人儿童相比，他们被认为需要支持，并且不太可能接受适当的治疗。 这种不成比例的服务提供可能会使一些儿童长期行为健康状况不佳 轨迹。为了减少 ADHD 的这种巨大差异，这种差异与儿童的发展轨迹密切相关 未来，我们必须确定与消除学前儿童多动症差异相关的可塑性因素。 对于表现出 ADHD 症状加重的学龄前儿童，建议采取行为干预措施 一线治疗，当针对家长和老师时最有效。然而，父母和 教师在按照建议的频率实施行为干预时遇到障碍 对教师的忠诚经常将父母视为遵守行为干预的障碍。在 目前的研究，我们认为父母和老师之间的关系是多动症的决定因素 通过影响行为干预的效力（和使用）来获得结果。我们的首要目标是发现、 设计并测试简短的干预措施，以提高家长和教师对行为干预的参与度 表现出 ADHD 症状加重的学龄前儿童（家长教育者行动响应；PEAR）。这 项目将分三个阶段进行：1）发现参与行为干预的障碍 家长和学前教育工作者以及利益相关者知情的战略，通过以下方式解决这些障碍 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 通过程序开发团队和快速原型设计实现目标 1（目标 2），以及 (3) 测试可接受性和 PEAR的可行性在小规模随机对照试验中对PEAR+行为干预进行了比较 仅对 14 个教室（42 名家长和 14 名 3-6 岁儿童的教育工作者）进行行为干预 多动症症状加重；目标3）。此 K23 反映了对多样性特别感兴趣的通知（NOT-OD- 20-31）、NIMH 战略计划目标 3（努力预防和治疗）以及 NIMH 呼吁预防或预防 通过重点宣传家长和教师，发现学前儿童多动症 (RFA-MH-21-230) 参与行为干预以改善实施，最终改善结果 来自历史上少数族裔背景且多动症症状加重的学龄前儿童。研究目标将 也可作为以下培训目标的务实学习的工具：1) 文化上的谦逊，2) 专业知识 制定干预措施以减少差异，3）先进的统计建模和测量模型 社会决定因素研究。这项 K23 指导奖将有助于 Zulauf-McCurdy 博士实现以下长期目标： 成为一名具有减少学前教育心理健康差异方面专业知识的独立调查员。