Improving ADHD Behavioral Care

Not Applicable

Completed

Conditions: ADHD

Interventions: Other: mehealth for ADHD
Other: Behavioral tools integrated within mehealth for ADHD software

Registration Number: NCT03628781

Lead Sponsor: Children's Hospital Medical Center, Cincinnati

Brief Summary: Though the most effective treatment for children with Attention Deficit Hyperactivity Disorder (ADHD) consists of combined medication and behavioral strategies, the vast majority of children with ADHD are treated with medication only. One reason for the low rates of behavioral treatment is that primary care pediatricians, not mental health professionals, are responsible for treating the vast majority of children with ADHD. The investigators have developed, tested, and are beginning to disseminate web-based software (mehealth for ADHD) that has been shown in randomized clinical trials to improve the quality of ADHD medication care delivered by pediatricians. The goal of the proposed study is to develop and test the integration of behavioral tools into the evidence-based myadhdportal.com software in order to improve access to behavioral treatment strategies, and ultimately improve outcomes for children with ADHD. The automated algorithms and decision rules the investigators have developed for creating and monitoring the behavioral tools ensure that behavioral treatments like daily report cards and token economies are delivered in a manner that is consistent with the evidence-base. The investigators are conducting a cluster randomized controlled trial in community pediatric settings to test whether integration of the behavioral tools into the myADHDportal.com software (1) increases rates of behavioral treatment; (2) facilitates better integrity of behavioral interventions when implemented; (3) improves functional impairment in children with ADHD; and (4) generates higher satisfaction with ADHD care. By continuing to expand the functionality of the myADHDportal.com software, the investigators are increasing patients' access to evidence-based care. This is especially critical for rural and underserved communities who have no or limited access to evidence-based mental health services. Moreover, by putting these behavioral tools in the hands of parents, teachers, and pediatricians, the investigators are making it more likely that children will receive a high quality of care that includes both medication management and behavioral strategies, thereby improving the overall treatment outcomes of children with ADHD.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 169

Inclusion Criteria

child in grades K-5
child has been diagnosed with ADHD by pediatrician or other mental health professional
child's ADHD care is currently being managed by pediatrician
if child is being prescribed ADHD medication, is currently on a stable dosage of medication
child is experiencing impairment at school as evidenced by a rating of 3 or higher on parent- or teacher-ratings of "academic progress" or "problems in classroom" and on the Impairment Rating Scale.

Exclusion Criteria

parent does not have access to a computer or smartphone

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
mehealth portal with no integrated behavioral tools	mehealth for ADHD	Patients in this arm will continue to use the mehealth for ADHD web-based software for ADHD care but will wait one year before getting access to the behavioral intervention features.
mehealth portal with integrated behavioral tools	Behavioral tools integrated within mehealth for ADHD software	Patients in this arm will continue to use the mehealth for ADHD web-based software for ADHD care but will also have access to a module that allows parents and teachers to develop and implement behavioral interventions such as daily report cards online.
mehealth portal with integrated behavioral tools	mehealth for ADHD	Patients in this arm will continue to use the mehealth for ADHD web-based software for ADHD care but will also have access to a module that allows parents and teachers to develop and implement behavioral interventions such as daily report cards online.

Primary Outcome Measures

Name	Time	Method
Rates of Behavioral Treatment	12 months after randomization	Parent-report of implementation of behavioral interventions on the Services Use in Children and Adolescents Parent Interview

Secondary Outcome Measures

Name	Time	Method
Teacher Rating of Classroom Performance on Impairment Rating Scale	6 months after randomization	Teacher rating of child's impairment on Classroom Performance on the Impairment Rating Scale. Items rated on a Likert scale ranging from 0 (no impairment) to 6 (extreme impairment).
Parent Rating of School Performance on Impairment Rating Scale	6 months after randomization	Parent rating of child's impairment on School Performance on the Impairment Rating Scale. Items rated on a Likert scale ranging from 0 (no impairment) to 6 (extreme impairment).
Teacher Rating of Academic Performance on Impairment Rating Scale	6 months after randomization	Teacher rating of child's impairment on Academic Performance on the Impairment Rating Scale. Items rated on a Likert scale ranging from 0 (no impairment) to 6 (extreme impairment).