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

项目总结 注意力缺陷/多动障碍(ADHD)的症状早在学龄前就出现了，而且 从小到大一直坚持下去。早期有效的治疗可以延缓典型的发育进展 患有多动症。尽管早期干预很重要，但历史上被划分为少数族裔的儿童不太可能 被确认为需要支持的儿童，与白人儿童相比，接受适当治疗的可能性较小。 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的行为健康状态 轨迹。为了减少ADHD患者的这种显著差异，这种差异与儿童的运动轨迹密切相关 在未来，关键是我们确定与消除学龄前儿童ADHD差异相关的可塑性因素。 对于表现出ADHD症状升高的学龄前儿童，建议采取行为干预措施 一线治疗，当它们同时针对家长和教师时，效果最好。然而，家长和 教师在以推荐的频率实施行为干预时遇到了障碍 忠诚度，教师经常将父母作为坚持行为干预的障碍。在 目前的研究表明，父母和教师之间的关系是ADHD的一个决定因素 通过影响行为干预的效力(和使用)而产生的结果。我们的首要目标是发现， 设计并测试一个简短的干预措施，以提高家长和教师对以下行为干预的参与度 表现出ADHD症状升高的学龄前儿童(家长-教育者行动反应；PEAR)。这个 该项目将分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利益相关者知情的战略，以通过 创新锦标赛(目标1)，(2)迭代设计和构建PEAR，以解决已确定的障碍 目标1通过程序开发团队和快速成型(目标2)，以及(3)测试可接受性和 梨在小规模随机对照试验+行为干预中的可行性比较 只对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 ADHD症状升高；目标3)。本K23反映了对多样性特别感兴趣的通知(非OD- 20-31)，NIMH战略计划目标3(努力预防和治疗)，以及NIMH呼吁预防或抢占 学龄前儿童注意缺陷多动障碍(RFA-MH-21-230)的研究 参与行为干预以改进实施，最终改善 来自历史上少数族裔背景、ADHD症状升高的学龄前儿童。研究的目的将是 还可作为务实学习以下培训目标的工具：1)文化谦逊，2)专业知识 制定干预措施以缩小差距，3)先进的统计建模和测量模型 社会决定因素研究。这项有指导意义的K23奖项将促进Zulauf-McCurdy博士的长期目标 成为一名独立的调查员，具有减少学龄前儿童心理健康差距的专业知识。

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.