Improving ADHD Behavioral Care
Condition: ADHD
Study type: Interventional

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.
    


Intervention name(s): Behavioral tools integrated within mehealth for ADHD software; mehealth for ADHD
Intervention type(s): Other; Other
Intervention description(s): Integrated functionality within the mehealth for ADHD software allows parents and teachers to set up and deliver behavioral interventions such as daily report card systems and home-based program such as star charts. Automated wizards lead parents and teachers through the process of selecting target behaviors and setting up reward schedules. Baseline data is gathered online and algorithms derive a set of behavioral goals for the child. Thereafter, parents or teachers record the child's performance directly into the software. Once behavioral monitoring begins, parents and teachers receive daily email or text communications from mehealth for ADHD alerting them to the daily rewards earned by their child. Finally, online algorithms exist that detect how a child is doing in meeting behavioral goals and prompt users to modify goals accordingly.; The mehealth for ADHD software has multiple functionalities including 1) online training regarding the American Academy of Pediatrics (AAP) ADHD guidelines; 2) an ADHD workflow wizard that guides pediatricians through the creation of an efficient office workflow to deliver quality ADHD care; 3) online collection of parent- and teacher-report ADHD rating scales for the assessment of ADHD as well as monitoring response to medication treatment; 4) integrated algorithms that automatically score rating scales in real time and provide pediatricians with assessment and treatment reports as well as immediate warnings; 5) a communication feature that allows parents, teachers, and pediatricians to communicate with each other; 6) an online pediatrician "report card"; and 7) a Plan-Do-Study-Act wizard that allows pediatricians to select a practice behavior to improve based on their report card and guides them through the creation of small tests of change to improve their office systems.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Behavioral intervention