IMPROVING PEDIATRICIANS' USE OF AD/HD GUIDELINES

描述（申请人摘要）：本提案回答了NIMH RFA MH-00-005：“开发、测试和实施创新干预措施， 多动症。“这项建议的核心是制定和实施一项 创新的干预，提出治疗注意力缺陷 在实验室环境中发现多动症（ADHD）有效， 儿科医生在一个社区环境中。拟议的初始阶段将描述 目前儿科在评估和治疗ADHD方面的实践。的 对干预措施的评价是纵向的，将有助于确定 采用疗效研究结果的障碍和促进因素， 社区儿科医生的现状及儿科医生坚持 关于儿童问题的议定书草案（总体功能和学术 与ADHD和共病障碍，以及他们的家庭。最后为 测试干预的持久性，我们将重新评估儿科医生的 干预后一年的评估和治疗实践。 ADHD是儿童中最常见的精神疾病，也是最常见的精神疾病之一。 少数儿童心理健康障碍，有一个有效的， 短期治疗（兴奋剂）。因此，它是一个理想的候选人 实践和传播研究（如NAMHC在桥接中定义的） 科学和服务，UNOCCAP监督委员会向NAMHC和 NIMH赞助的“贝尔蒙特报告”）。然而，功效研究的传播 研究结果的速度超过了向儿科医生传播知情方法的速度。 这种知识差距导致了可变的，往往是劣质的，儿科 社区中的ADHD实践。为了将ADHD知识从 “实验室的日常实践，”美国儿科学会（AAP）是 起草ADHD临床实践指南我们的干预提出了这些 沿着儿科医生指南， 注意力缺陷多动症的评估和治疗 这项提案涉及100名儿科医生， 横断面设计和200名儿童在一个随机的，2年的纵向 study.我们将：1）描述ADHD的评估和治疗程序， 社区儿科医生，2）评估的实施和影响， 旨在提高AAP ADHD指南采用率的干预措施; 3）评估 儿科医生采用AAP指南的程度和预测因素; 4)比较儿童的服务使用和结果（AAP指南与 传统实践）; 5）描述治疗依从性的预测因素; 6） 跟踪研究人员诊断为ADHD的儿童，但不是他们的 儿科医生;最后7）评估ADHD的直接和间接成本。

DESCRIPTION (Applicant's abstract): This proposal answers the NIMH RFA MH-00-005: "Developing, Testing and Implementing Innovative Interventions for ADHD." This proposal centers on the development and implementation of an innovative intervention for presenting treatments of Attention Deficit Hyperactivity Disorder (ADHD) found efficacious in a laboratory setting to pediatricians in a community setting. The proposed initial phase will delineate current pediatric practice in the assessment and treatment of ADHD. The evaluation of the intervention is longitudinal and will aid in identifying barriers to and facilitators of the adoption of efficacy study results by pediatricians in the community and the effects of pediatrician's adhering to the proposed protocol or not on children (overall functioning and academic measures) with ADHD and comorbid disorders, and their families. Finally, to test the durability of the intervention, we will reassess the pediatrician's assessment and treatment practices one year after the intervention. ADHD is the most commonly diagnosed mental illness in children and one of the few childhood mental health disorders for which there is an efficacious, short-term treatment (stimulant medications). Thus, it is an ideal candidate for practice and dissemination research (as defined by the NAMHC in Bridging Science and Service, The UNOCCAP Oversight Board report to NAMHC and the NIMH-sponsored "Belmont Report"). However, the spread of efficacy research findings has outpaced the dissemination of informed methods to pediatricians. This knowledge gap has contributed to variable, and often inferior, pediatric ADHD practices in the community. In an effort to move ADHD knowledge from the "the laboratory to daily practice," the American Academy of Pediatrics (AAP) is drafting ADHD Clinical Practice Guidelines. Our intervention presents these guidelines to pediatricians along with a practical procedural manual on the assessment and treatment of ADHD. This proposal involves 100 pediatricians working with 800 children in a cross-sectional design and 200 children in a randomized, 2-year longitudinal study. We will: 1) describe ADHD assessment and treatment procedures of community pediatricians, 2) evaluate the implementation and impact of an intervention designed to enhance adoption of the AAP ADHD guidelines; 3) assess the extent and predictors of adoption of the AAP guidelines by pediatricians; 4) compare the service use and outcomes of children (AAP guidelines versus traditional practice); 5) describe predictors of adherence to treatment; 6) follow children diagnosed with ADHD by the researchers, but not their pediatricians; and finally 7) assess direct and indirect ADHD costs.