Effectiveness of Collaborative Services in Primary Care for Treating Children With Behavior Disorders
Condition: Attention Deficit and Disruptive Behavior Disorders
MeSH terms: Mental Disorders; Problem Behavior; Attention Deficit and Disruptive Behavior Disorders
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      This study will evaluate the effectiveness of a doctor-office collaborative care approach in
      treating children with disruptive behavior problems in the pediatric primary care setting.
    

Detailed description: 
      Disruptive behavior problems (DBP) involve a behavioral tendency of children and adolescents
      to continually disregard basic social rules and the rights of others. Symptoms of DBP include
      problematic aggression, antisocial tendencies, serious defiance of rules, and temper
      tantrums. Children or adolescents with DBP display this type of behavior at school, home, or
      other social situations, often affecting family life, academic performance, and relations
      with others. The causes of DBP are believed to be both environmental and biological. Children
      most at risk for DBP are those who have low birth weight, attention deficit hyperactivity
      disorder (ADHD), or a history of abuse or neglect. Behavioral therapy that targets parent and
      child skills has shown to be the most effective treatment for DBP. This study will evaluate
      the effectiveness of a doctor-office collaborative care (DOCC) approach in treating children
      with DBP in the pediatric primary care setting. The study is a continuation and extension of
      the parent study, Services for Kids in Primary Care (SKIP).

      Participants in this single blind study will be randomly assigned to one of two treatment
      groups: doctor-office collaborative care (DOCC) or treatment as usual (TAU). Treatment will
      take place at one of eight participating primary care practices, each randomly assigned to
      either DOCC or TAU. All participants will undergo an initial assessment that will include a
      clinical evaluation with the care manager and research questionnaires. The families
      participating in the practices assigned to DOCC will receive cognitive behavioral therapy
      (CBT), parent management training (PMT), and ADHD management training. Participants will also
      complete ongoing behavioral questionnaires. There will be on average 12 DOCC sessions,
      lasting between 30 and 90 minutes, held in the primary care office. The sessions will occur
      over a 3- to 6-month period. The families participating in the practices assigned to TAU will
      receive a full review of initial assessment findings and specific recommendations for
      services in the community that would meet the clinical needs of the child participant. The
      parent/guardian of the child will also be provided psychoeducational resources via Web sites,
      literature, or reference materials. Lastly, participants in TAU will receive a follow-up call
      between 2 and 4 weeks after the initial assessment to assist with finding community programs
      or additional resource identification. All participants in both groups will undergo follow-up
      assessments at Months 6, 12, 18, 24, and 30 after the initial assessment. Each assessment
      will last 2 to 3 hours and will include self-report and interview questionnaires.
    

Intervention name(s): Doctor-office collaborative care (DOCC) management; Treatment as usual (TAU)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): DOCC is an evidence-based psychosocial treatment approach that incorporates (1) adaptation of an evidence-based collaborative care approach using the chronic care model and participatory management theory to enhance training, implementation, and sustainability; (2) revised protocol content that includes medication management for ADHD, brief anxiety management, and attention to parental/partner dysfunction; (3) technological developments to facilitate screening/assessment, monitoring, and communication; and (4) an improved methodology that includes new samples, measures, and settings.; TAU involves routine care: psychoeducation and referral to outside providers.
Other intervention name(s): DOCC; PORT
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Behavior Problems; Behavior Disorders