Metacognitive ADHD Telehealth Intervention for Work-performance Enhancement (Work-MATE)
Condition: ADHD
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Adults with Attention-deficit hyperactivity disorder (ADHD) experience poor occupational
      performance at work compare to adults without ADHD, manifested at tendencies toward
      unemployment, job instability, work accidents, and sickness absences. This poor occupational
      performance at work may be partly caused by difficulties at executive functions (EF)
      abilities, and at the ability to set and attain goal directed work-activities at a
      satisfactory manner. Therefore, improvement at those abilities may followed by occupational
      performance at work enhancement of adults with ADHD. Such improvement may enhance adults with
      ADHD quality of life.

      Despite the wide-ranging implications of poor occupational performance at work of adults with
      ADHD, treatments which focus at this component improvement among adults with ADHD are lack.

      The Metacognitive ADHD Telehealth intervention for Work-performance Enhancement (Work-MATE)
      is an innovative program that aim to improve occupational performance at work of adults with
      ADHD, by enhancing their EF abilities, self-awareness, and personal strategy use.

      This program was established based on existing fundamental models and approach, (1) The World
      Health Organization's international classification of functioning, disability and health
      (ICF) (WHO, 2001), (2) Person-Environment-Occupation-Performance model (Baum, Christiansen, &
      Bass-Haugen, 2015) (3) The Dynamic Interactional Model of cognition (DIM; Toglia, 2018) and
      the Multicontex approach (Toglia, 2018) which based on the it, and (4) Telehealth as
      service-delivering model.

      The Work-MATE aim to promote self-awareness and self-generation of personal strategies and
      increase efficiency strategy use across meaningful purposeful everyday work activities (i.e.,
      goal directed work-activities). It is a short, synchronous and hybrid teleintervention
      program of eleven 1-hour weekly individual sessions, focused directly on occupational
      performance at work enhancement of adults with ADHD.
    

Detailed description: 
      Research Aim:

      To develop and evaluate effectiveness of Metacognitive ADHD Telehealth intervention for
      Work-performance Enhancement (Work-MATE), of adults with ADHD.

      Hypotheses:

      The study sample (n=46) includes adults with ADHD, after confirmation of inclusion and
      exclusion criteria and symptoms consistency of ADHD. Participants enrolled randomly into two
      groups:

        1. Group A (n=31)- received treatment immediately after the first assessment.

        2. Group B (n =16)- was reassessed 10-11 weeks after the first assessment (the length of
           the treatment process), and then received treatment.

      Both groups were reassessed at the end of the treatment (second assessment for group A and
      third assessment for group B). An additional assessment was performed three months after the
      end of treatment.

      The hypotheses are presented in three stages:

      Stage 1:

        1. A comparison of the characteristics of study groups (A and B) participants as a
           preliminary stage to their unification as one group (n=46).

           Hypothesis 1: Differences will not be found in the demographic and occupational
           characteristics of participants when assessed using demographic and occupational
           questionnaires, and the ADHD characteristics using the Brown Attention-Deficit Disorder
           Scales (BADDS).

        2. To examine the change in group B (n = 16) prior to treatment.

      Hypothesis 2: Differences will not be found between assessment 1 and assessment 2 before the
      treatment in the following variables:

      2. a. EF abilities- measured by Behavior Rating Inventory of Executive Function-Adult version
      (BRIEF-A) 2. b. occupational performance at work- evaluated by performance and satisfaction
      with performance scores as measured with the Canadian Occupational Performance Measure
      (COPM).

      2. c. Quality of life- evaluated by Adult ADHD Quality of Life Questionnaire (AAQoL).

      2. d. Organization in time ability- evaluated by Time Organization and Participation Scale
      (TOPS).

      2. e. ADHD characteristics- evaluated by BADDS questionnaire.

      Stage 2: Effectiveness of the Treatment

      1. Examination of the effectiveness of the treatment process within both study groups (A and
      B) (n = 46), before and after treatment, and three months after its completion.

      Hypothesis 3: Differences will be found in both study groups (research and comparison) before
      and after treatment, and after a follow-up assessment three months later, regarding:

      3. a. EF abilities- measured by BRIEF-A. 3. b. occupational performance at work- evaluated by
      performance and satisfaction with performance scores as measured with the COPM.

      3. c. Quality of life- evaluated by AAQoL. 3. d. Organization in time ability- evaluated by
      TOPS. 3. e. ADHD characteristics- evaluated by BADDS questionnaire.
    

Intervention name(s): The Metacognitive ADHD Telehealth intervention for Work-performance Enhancement (Work-MATE)
Intervention type(s): Behavioral
Intervention description(s): The Metacognitive ADHD Telehealth intervention for Work-performance Enhancement (Work-MATE) is an innovative program that aim to improve occupational performance at work of adults with ADHD, by enhancing their EF abilities, self-awareness, and personal strategy use.
The Work-MATE is a short, synchronous and hybrid teleintervention program of eleven 1-hour weekly individual sessions. It offers a written standardized protocol, which include uniform structure of each intervention session and pool of therapy aids (for self-tailored matching by occupational therapists).
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: The study was designed as a randomized controlled and crossover trial to evaluate the evaluate the effect of the Work-MATE program on occupational performance at work of adults with ADHD.
The first Intervention Group (A) received the Work-MATE intervention. After a crossover switching trial, the second Intervention Group (B) received the Work-MATE intervention in order. All evaluations were online, in similar environmental conditions.
The Ethics Committee of the University of Haifa approved the study.
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment
Keywords: Work Performance; Occupational Performance; Executive Functions; Quality of Life; Organization in Time