Exploring the Group Visit Model for Pediatric ADHD Management in the Medical Home

Not Applicable

Completed

• Conditions: ADHD
• Interventions: Behavioral: ADHD Group Curriculum

• Registration Number: NCT02145793
• Lead Sponsor: Indiana University

Brief Summary

Attention deficit hyperactivity disorder (ADHD) affects 8% of US youth. Even though evidence shows medications are effective in reducing ADHD symptoms, many families experience ongoing parenting stress around parent-child interactions. Children often have ongoing impairments in functioning. ADHD is a common condition identified and managed by primary care pediatricians. However current care in the clinic is not optimal to address parents' and children's needs around ADHD chronic care. Time is the biggest barrier. Group visits are a viable option to improve pediatric ADHD care, but requires extensive study. The goal of this proposed study is to test the feasibility and effectiveness of the group visit model for ADHD management within pediatric primary care. This study will be a randomized feasibility study that will generate important pilot data, as well as result in an innovative, exportable pediatric ADHD group curriculum for primary care practice.

Detailed Description

The specific research aims of this proposal are:

Aim 1: Develop and test a group curriculum for parents of children (age 6 to 18 years) with ADHD to increase parental knowledge about ADHD and self-confidence in managing issues related to their child's functioning in school and home.

Aim 2: Develop and test a group curriculum for children (age 6 to 18 years) with ADHD to teach social and educational skills to improve adaptive functioning at home and school.

Aim 3: To assess any added benefits to the parents, children and providers (related to group visit logistics and satisfaction) the group visit model has over usual care.

Aim 4: To assess whether the group visit model can be done efficiently and effectively in the setting of an actual general pediatric practice.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2012-06
• Primary Completion: 2013-10
• Study Completion: 2013-11
• Status Verified: 2014-05
• Study First Submitted: 2014-05-18
• Study First Submitted QC: 2014-05-20
• Last Update Submitted: 2014-05-22
• Study First Posted: 2014-05-23
• Last Update Posted: 2014-05-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 56

Inclusion Criteria

• children with ADHD and their parents
• children receiving routine ADHD follow-up care at the study clinic
• if on medication, must be "stable" for 3 months and therefore not needing monthly clinic appointments to titrate medication

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Exclusion Criteria

• conduct disorder
• autism
• moderate to severe intellectual disability

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
ADHD Group Curriculum	ADHD Group Curriculum	Participants assigned to the group visit intervention agree to participate in 5 group visits every 3 months rather than individual ADHD follow-up visits to the clinic. Parents and children participate in separate but simultaneously run groups. Group portion is 60 minutes and then parent-child dyads complete individual visits for medication titration and physical exam.

Primary Outcome Measures

Name	Time	Method
Number of clinic visits during study period	12 months	Feasibility of group visit model was measured as number of visits to the clinic by chart review. We also looked at the number of group visits a family attended based on the sign in sheet provided at the beginning of each session.

Secondary Outcome Measures

Name	Time	Method
Child functioning at school	baseline	teachers were invited to provide rating of child's adaptive functioning at school. Parent given the tool at time of enrollment and instructed to give to teacher as per clinical care guidelines.
Parent-rated ADHD symptoms	12 months	Parents complete validated Vanderbilt Rating Scale to report child symptoms of ADHD. Used to assess response to treatment, usually medication.
Child functioning at home	12 months	Parents report of child's adaptive functioning in the home setting using the Home Situations Questionnaire.
Teacher report of child's ADHD symptoms	baseline	teachers received the validated Vanderbilt rating scale to rate student's ADHD symptoms in the classroom. Parents were given the tool at time of enrollment and asked to give to teacher as per clinical care guidelines. Monitors impact of ADHD treatment, usually medication.
Parenting self-efficacy	Baseline	Parent reported sense of confidence using the Parenting Sense of Confidence Scale
Parental knowledge, satisfaction towards medication treatment	baseline	Parent report of knowledge, attitudes and satisfaction towards medication experiences with ADHD medication treatment
teacher rating of child's functioning in school	12 months	teachers were invited to provide rating of child's adaptive functioning at school. Parent given the tool at time of enrollment and instructed to give to teacher as per clinical care guidelines.
teacher report of child's ADHD symptoms in school	12 months	teachers received the validated Vanderbilt rating scale to rate student's ADHD symptoms in the classroom. Parents were given the tool at time of enrollment and asked to give to teacher as per clinical care guidelines. Monitors impact of ADHD treatment, usually medication.
Parenting Self-efficacy	12 months	Parent-reported sense of confidence using Parenting Sense of Confidence scale
Parent knowledge and satisfaction towards medication treatment	12 months	Parent report of knowledge, attitudes and satisfaction towards medication experiences with ADHD medication treatment
Quality of Life	12 months	Capture parent rating of quality of life related to ADHD using the Child Health Questionnaire-28 validated tool.

Trial Locations

Locations (1)

General Pediatrics Clinic Medical Service Area 1 in Riley Hospital for Children at IU Health; 🇺🇸 Indianapolis, Indiana, United States