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

描述（由申请人提供）：本研究的长期目标是确定在社区中为ADHD青少年提供的服务中增加治疗计划（如“视野计划”（CHP））的价值。仍然缺乏关于ADHD青少年有效心理治疗的数据。这是有问题的，因为药物作为唯一的治疗形式对大多数年轻人来说是不够的，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候。具体而言，本研究的目的是：1）评估的课后计划模式和咨询模式的卫生防护中心的相互比较，并与社区护理的效果，2）估计的成本效益比的两个层次的服务，和3）确定调解人和调解人的治疗反应的两个卫生防护中心的干预模式。此外，研究结果应告知治疗决定哪些儿童需要哪一级护理。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，这些教师接受过培训，并就CHP方法提供持续咨询（CHP-C）。在五年内，将在两个地点的七所中学招募315名符合ADHD标准的参与者，并随机分配接受CHP-AS，CHP-C或社区护理。将衡量为所有三种情况提供服务的成本以及症状和减值结果。数据收集将在儿童参与该项目的整个学年持续进行。此外，将在基线、治疗后即刻和治疗后6个月进行正式评价。与初步研究的结果一致，预计受试者对两种活性治疗条件的反应将有所不同。将收集评估结果，以确定治疗反应的潜在调节因素和介导因素，并将其纳入分析中，以确定可能预测治疗反应的儿童和父母特征以及与治疗过程相关的变量（例如，预测答案的方法。

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.