Improving ADHD Behavioral Care Quality in Community-Based Pediatric Settings
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 169
- Locations
- 1
- Primary Endpoint
- Rates of Behavioral Treatment
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Single (Outcomes Assessor)
Eligibility Criteria
- Ages
- 5 Years to 12 Years (Child)
- Sex
- All
- Accepts Healthy Volunteers
- No
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
Arms & Interventions
mehealth portal with integrated behavioral tools
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.
Intervention: Behavioral tools integrated within mehealth for ADHD software (Other)
mehealth portal with integrated behavioral tools
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.
Intervention: mehealth for ADHD (Other)
mehealth portal with no integrated behavioral tools
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.
Intervention: mehealth for ADHD (Other)
Outcomes
Primary Outcomes
Rates of Behavioral Treatment
Time Frame: 12 months after randomization
Parent-report of implementation of behavioral interventions on the Services Use in Children and Adolescents Parent Interview
Secondary Outcomes
- Teacher Rating of Classroom Performance on Impairment Rating Scale(6 months after randomization)
- Parent Rating of School Performance on Impairment Rating Scale(6 months after randomization)
- Teacher Rating of Academic Performance on Impairment Rating Scale(6 months after randomization)
Investigators
Jeff Epstein
Professor
Children's Hospital Medical Center, Cincinnati