2/2-Multisite Study of School Based Treatment Approaches for ADHD Adolescents

多动症青少年学校治疗方法的 2/2 多中心研究

• 批准号: 7897888
• 负责人: Joshua Morris Langberg
• 金额: $ 34.31万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7897888
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DESCRIPTION (provided by applicant): The long term objective of this study is to determine the value of adding treatment programs like the Challenging Horizons Program (CHP) to the services available to youth with ADHD in a community. There continues to be a lack of data on effective psychosocial treatments for adolescents with ADHD. This is problematic, as medication is inadequate for most youth as a sole form of treatment and adolescence is a time where the impairment associated with ADHD becomes increasingly dangerous, life-altering, and serious. Specifically, this study aims to: 1) Evaluate the efficacy of the after-school program model and the consultation model of CHP as compared to each other and as compared to community care, 2) Estimate cost-effectiveness ratios for each of the two levels of services, and 3) Identify moderators and mediators of treatment response for the two CHP intervention models. In addition, the findings should inform treatment decisions about which children need which level of care. Treatment services are delivered either through an after-school program (CHP-AS) or through teachers employed by the school who are trained and provided with ongoing consultation on the CHP methods (CHP-C). Over five years 315 participants who meet criteria for ADHD will be recruited at seven middle schools across two sites and randomly assigned to receive either the CHP-AS, CHP-C or community care. Costs of providing the services for all three conditions will be measured as well as symptom and impairment outcomes. Data collection will occur on an ongoing basis over the academic year of a child's participation in the project. In addition, formal evaluations will occur at baseline, immediately post-treatment, and 6 months post-treatment. Consistent with findings from preliminary studies it is expected that response to both active treatment conditions will vary across participants. Assessments will be collected that identify potential moderators and mediators of treatment response and these will be included in the analyses in order to identify child and parent characteristics that may predict response to treatment as well as variables related to the treatment process (e.g., attendance) that predicts response. PUBLIC HEALTH RELEVANCE: The lack of adequate treatments for youth with problems related to substance use, automobile accidents, school failure and other difficulties associated with adolescents with ADHD presents a serious public health problem. This study evaluates the effectiveness and cost associated with two emerging comprehensive treatment options for youth and identifies characteristics of the teens (moderators) and the treatment (mediators) that predict positive outcomes. The development of a cost-effective treatment for young adolescents with ADHD that can be integrated into schools and the community will provide invaluable assistance to the public health field and address problems across multiple sectors of public well being.

描述(由申请人提供)：这项研究的长期目标是确定在社区为患有ADHD的青少年提供的服务中增加像挑战地平线计划(CHP)这样的治疗计划的价值。仍然缺乏对患有ADHD的青少年进行有效的心理社会治疗的数据。这是有问题的，因为药物治疗对大多数年轻人来说是不够的，作为唯一的治疗形式，而青春期是与ADHD相关的损害变得越来越危险、改变生活和严重的时期。具体地说，本研究的目的是：1)评估卫生防护中心的课后计划模式和咨询模式在彼此之间以及与社区护理相比的效果；2)估计两种服务水平的成本-效果比；3)确定两种卫生防护干预模式的治疗反应的调节因素和中介因素。此外，这些发现应该为治疗决策提供信息，即哪些儿童需要哪种级别的护理。治疗服务是通过课后计划(CHP-AS)或通过学校雇用的教师提供的，这些教师接受了CHP方法的培训并提供了持续的咨询(CHP-C)。在五年的时间里，315名符合ADHD标准的参与者将被招募到两个地点的七所中学，并随机分配接受CHP-AS、CHP-C或社区护理。为所有三种情况提供服务的成本将以及症状和损害后果进行衡量。数据收集将在儿童参与该项目的整个学年内持续进行。此外，正式评估将在基线、治疗后立即和治疗后6个月进行。与初步研究的结果一致，预计参与者对这两种积极治疗条件的反应将有所不同。将收集确定治疗反应的潜在主持人和调解人的评估，这些评估将被包括在分析中，以便确定可能预测治疗反应的儿童和父母特征以及与预测治疗反应的治疗过程(例如，出席情况)有关的变量。 与公共卫生有关的问题：青少年缺乏与药物使用、车祸、失学和其他与青少年多动症有关的困难的适当治疗，这是一个严重的公共卫生问题。这项研究评估了两种新出现的青少年综合治疗方案的有效性和成本，并确定了青少年(主持人)和治疗(调解人)的特点，预测了积极的结果。为患有ADHD的青少年开发一种可纳入学校和社区的具有成本效益的治疗方法，将为公共卫生领域提供宝贵的援助，并解决公共福利多个部门的问题。