A Pilot Study of a Remote Attention-Deficit/Hyperactivity Disorder Monitoring Program (RAMP) for Children in Rural Areas
Overview
- Phase
- Not Applicable
- Intervention
- RAMP Reports
- Conditions
- Attention-deficit/Hyperactivity Disorder
- Sponsor
- IDeA States Pediatric Clinical Trials Network
- Enrollment
- 36
- Locations
- 4
- Primary Endpoint
- Evaluate completion of clinical assessments by caregivers and teachers.
- Status
- Recruiting
- Last Updated
- 4 days ago
Overview
Brief Summary
RAMP is a pilot study examining the use of an Attention-Deficit/Hyperactivity Disorder (ADHD) Monitoring Program during the early stages of treating ADHD in children living in rural settings. This trial will enroll 36 caregiver/infant dyads across 2 sites and will evaluate feasibility endpoints rather than clinical outcomes. Enrolled participants will be randomized 1:1 to the intervention group (RAMP reports) or control group (digital education handouts). The study duration is 10 months, including start-up, enrollment and intervention, and data analysis and manuscript submission.
Detailed Description
The RAMP study is designed to examine the use of an attention-Deficit/Hyperactivity Disorder (ADHD) Monitoring Program during the early stages of treating ADHD in children living in rural settings. It is a multi-site pilot study conducted across two Institutional Development Award (IDeA) States Pediatric Clinical Trials Network (ISPCTN) sites in conjunction with four practices with high rural and/or underserved populations. The Remote ADHD Monitoring Program (RAMP) will include provider ADHD Best Practice education, caregiver and teacher prompts for frequent RAMP Reports of inattention and hyperactivity symptoms and a provider dashboard with enrolled children. The RAMP Report includes the publicly available Vanderbilt Rating Scales (henceforth shortened to Vanderbilt Assessment), which is a commonly used, guideline-recommended tool for both diagnosis and management of ADHD for use by parents and teachers. Families will be approached until 36 caregiver/child dyads are enrolled. Those enrolled will be randomized 1:1 to either the intervention group or control group. The intervention group will be enrolled in the RAMP, with prompts to provide frequent reports including ADHD symptoms. The control group will provide ADHD symptom reports through paper forms (usual care), on a provider determined schedule. The intervention group will be enrolled in the RAMP platform and will receive text-based requests for reports with embedded links to fill out the RAMP questionnaires weekly for 4 weeks, then monthly for 2 months. The control group will receive digital education handouts about age-appropriate pediatric health topics weekly for 4 weeks, then monthly for 2 months. For the intervention group, the child's teacher can voluntarily return the RAMP questionnaires as well, but will not have direct contact with the study team. The child's provider will also be a participant for the intervention group, and will receive requests to review the submitted RAMP reports. The primary endpoint for this study is to evaluate the number of clinical assessments per participant that are completed by caregivers and teacher and returned to providers for ADHD management. The secondary endpoint for this study is to evaluate the proportion of all submitted RAMP reports that are reviewed by providers. The results of this pilot will be used to design a full-scale efficacy trial in additional rural sites to expand diversity and assess generalizability.
Investigators
Eligibility Criteria
Inclusion Criteria
- •The child must
- •be under the care of a participating provider
- •be aged 5-11 at enrollment
- •have a diagnosis of ADHD
- •be initiating stimulant medication for treatment for the first time or have not received stimulant medication for the last 6 months
- •be attending in-person elementary school
- •The Primary caregiver must
- •be willing and legally able to give consent
- •have access to a smartphone
- •be English-speaking
Exclusion Criteria
- •has serious mental health comorbidities (Children with depression, anxiety, oppositional defiant disorder will be permitted to participate. Children with schizophrenia, bipolar disorder, conduct disorder and those who have been hospitalized for any mental health condition will be excluded from the study.)
- •has severe neurodevelopment disorders (Children with well-controlled seizure disorders will be permitted to participate.)
- •is currently receiving, or previously received, atypical antipsychotic medication treatment
- •is or becomes pregnant
Arms & Interventions
RAMP Reports
Submit RAMP reports weekly for 4 weeks and then monthly for 2 months.
Intervention: RAMP Reports
Digital Education Handouts
Standard of care determined by the treating healthcare provider and digital education handouts (attention controls) distributed by the study team weekly for 4 weeks and then monthly for 2 months.
Intervention: Digital Education Handouts
Outcomes
Primary Outcomes
Evaluate completion of clinical assessments by caregivers and teachers.
Time Frame: 6 Months
The number of clinical assessments (paper assessments in control and RAMP Reports in intervention) per participant that are completed by caregivers and teachers and returned to providers for ADHD management.
Secondary Outcomes
- Evaluate provider acceptability of the RAMP through utilization measures.(6 Months)