Educating and Supporting Primary Care Providers in the Implementation of Evidence-based Practices for ADHD

Not Applicable

Completed

Conditions: Attention Deficit Hyperactivity Disorder

Interventions: Behavioral: Supporting Practice for ADHD (SPA)

Registration Number: NCT02271386

Lead Sponsor: Children's Hospital of Philadelphia

Brief Summary: Although numerous studies have demonstrated that a high percentage of primary care providers (PCPs) are knowledgeable about the American Academy of Pediatrics' guidelines for managing ADHD, many fail to implement these guidelines correctly. The goal of this project is to increase the use of evidence-based practices (EBP) for assessing and treating children with ADHD between 5 and 12 years in the context of primary care practice. This randomized controlled trial will evaluate the whether a 3-part intervention (education about ADHD management and communication training, collaborative consultation, and performance feedback regarding use of EBPs) is effective in improving EBP use among primary care providers.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 895

Inclusion Criteria

Non-resident clinician (physician or nurse practitioner) at participating site

Exclusion Criteria

Residents

Secondary Subjects: Families

Inclusion Criteria:

Children aged 5-12 years receiving care from a clinician enrolled in the study for ADHD and their parents

Exclusion Criteria:

Autism spectrum disorder

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Control	Supporting Practice for ADHD (SPA)	Clinicians in the control arm will receive no intervention for the first 8 months of the study, then will receive the full SPA intervention for the last 8 months of the study.
Intervention	Supporting Practice for ADHD (SPA)	Clinicians in the intervention arm will receive the three-part intervention (Supporting Practice for ADHD, or SPA) which includes: education about ADHD management and communication training, collaborative consultation, and performance feedback, for the first 8 months of the study.

Primary Outcome Measures

Name	Time	Method
Number of Patients Who Were Sent the Parents Rating Scale	Intervention Period (8 months)	This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was sent out during the intervention interval
Number of Patients Whose Teacher Rating Scale Was Returned	Intervention Period (8 months)	This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was received by the clinician during the intervention interval
Number of Patients Whose Parent Rating Scale Was Returned	Intervention Period (8 months)	This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was received by the clinician during the intervention interval
Number of Patients Who Were Sent the Teacher Rating Scale	Intervention Period (8 months)	This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was sent out during the intervention interval

Secondary Outcome Measures

Name	Time	Method
Number of Patients Who Were Sent the Parent Rating Scale- by MOC Status	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation.
Number of Patients Whose Parent Rating Scale Was Returned- by Feedback Call Participation	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call.
Number of Patients Who Were Sent the Teacher Rating Scale- by MOC Status	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation.
Number of Patients Whose Parent Rating Scale Was Returned- by MOC Status	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation.
Number of Patients Who Were Sent the Parent Rating Scale- by Feedback Call Participation	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call.
Number of Patients Whose Teacher Rating Scale Was Returned- by Feedback Call Participation	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call.
Number of Patients Who Were Sent the Parent Rating Scale - by MOC Status	Baseline Period (8 months)	We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the baseline period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation.
Number of Patients Whose Teacher Rating Scale Was Returned- by MOC Status	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation.
Implementation Outcome: Number of Clinicians Who Completed All 3 Educational Presentations	Intervention Period (8 months)	We assessed the proportion of clinicians randomized to the intervention group that completed all 3 educational presentations.
Number of Patients Who Were Sent the Teacher Rating Scale- by Feedback Call Participation	Intervention Period (8 months)	We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call.
Implementation Outcome: Number of Clinicians Who Used the Collaborative Consultation Component	Intervention Period (8 months)	We calculated the proportion of clinicians in the intervention group that posted in the online networking site which was used to facilitate collaborative consultation.
Implementation Outcome: Number of Clinicians Who Participated in at Least One Performance Feedback Call	Intervention Period (8 months)	We calculated the proportion of clinicians in the intervention group who participated in at least one of the four performance feedback calls that were held during the study period.
Implementation Outcome: Number of Clinicians Who Participated in All Intervention Components and Attested to Fulfilling MOC Requirements	Intervention Period (8 months)	We calculated the proportion of clinicians in the intervention group who completed all components of the intervention and attested to fulfilling MOC requirements.