Educating and Supporting Primary Care Providers in the Implementation of Evidence-based Practices for ADHD

Study Overview
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Brief Summary
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Although numerous studies have demonstrated that a high percentage of primary care providers (PCPs) are knowledgeable about the American Academy of Pediatrics' guidelines for managing ADHD, many fail to implement these guidelines correctly. The goal of this project is to increase the use of evidence-based practices (EBP) for assessing and treating children with ADHD between 5 and 12 years in the context of primary care practice. This randomized controlled trial will evaluate the whether a 3-part intervention (education about ADHD management and communication training, collaborative consultation, and performance feedback regarding use of EBPs) is effective in improving EBP use among primary care providers.

Official Title
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Educating and Supporting Primary Care Providers in the Implementation of Evidence-based Practices for ADHD

Conditions
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Attention Deficit Hyperactivity Disorder

Intervention / Treatment
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* Behavioral: Supporting Practice for ADHD (SPA)


Participation Criteria
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Eligibility Criteria
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Primary Subjects: Clinicians Inclusion Criteria: Non-resident clinician (physician or nurse practitioner) at participating site Exclusion Criteria: Residents Secondary Subjects: Families Inclusion Criteria: Children aged 5-12 years receiving care from a clinician enrolled in the study for ADHD and their parents Exclusion Criteria: Autism spectrum disorder

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Clinicians in the intervention arm will receive the three-part intervention (Supporting Practice for ADHD, or SPA) which includes: education about ADHD management and communication training, collaborative consultation, and performance feedback, for the first 8 months of the study. | Behavioral: Supporting Practice for ADHD (SPA)<br>* The SPA intervention will last for 8 months for each study arm (first 8 months of the study for the intervention group, last 8 months for the control group). The intervention includes 3 components: 1) a series of web-based educational presentations to provide education to providers about evidence-based practice for managing ADHD and strategies for promoting effective communication with families 2) Collaborative consultation designed to address clinical issues arising in practice will be provided by members of the study team. 3) Providers will be given systematic performance feedback with regard to their use of evidence-based practices for ADHD every 2 months during the 8-month intervention period.<br>|
| Other: Control<br>Clinicians in the control arm will receive no intervention for the first 8 months of the study, then will receive the full SPA intervention for the last 8 months of the study. | Behavioral: Supporting Practice for ADHD (SPA)<br>* The SPA intervention will last for 8 months for each study arm (first 8 months of the study for the intervention group, last 8 months for the control group). The intervention includes 3 components: 1) a series of web-based educational presentations to provide education to providers about evidence-based practice for managing ADHD and strategies for promoting effective communication with families 2) Collaborative consultation designed to address clinical issues arising in practice will be provided by members of the study team. 3) Providers will be given systematic performance feedback with regard to their use of evidence-based practices for ADHD every 2 months during the 8-month intervention period.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Patients Who Were Sent the Parents Rating Scale | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was sent out during the baseline interval | Baseline Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was received by the clinician during the baseline interval | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was sent out during the baseline interval | Baseline Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was received by the clinician during the baseline interval | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Parents Rating Scale | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was sent out during the intervention interval | Intervention Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a parent rating scale was received by the clinician during the intervention interval | Intervention Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was sent out during the intervention interval | Intervention Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned | This measure is based on chart review of patients of clinicians in each study arm (up to 4 patients per clinician) and reflects whether there is evidence that a teacher rating scale was received by the clinician during the intervention interval | Intervention Period (8 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Patients Who Were Sent the Parent Rating Scale - by MOC Status | We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the baseline period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Baseline Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned- by MOC Status | We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the baseline period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale- by MOC Status | We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the baseline period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Baseline Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned- by MOC Status | We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the baseline period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Parent Rating Scale- by MOC Status | We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Intervention Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned- by MOC Status | We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Intervention Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale- by MOC Status | We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Intervention Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned- by MOC Status | We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not complete Maintenance of Certification (MOC) attestation. | Intervention Period (8 months) | 
| Number of Patients Who Were Sent the Parent Rating Scale- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the baseline period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Baseline Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the baseline period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the baseline period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Baseline Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the baseline period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Baseline Period (8 months) | 
| Number of Patients Who Were Sent the Parent Rating Scale- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a parent rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Intervention Period (8 months) | 
| Number of Patients Whose Parent Rating Scale Was Returned- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a parent rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Intervention Period (8 months) | 
| Number of Patients Who Were Sent the Teacher Rating Scale- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a teacher rating scale was sent out during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Intervention Period (8 months) | 
| Number of Patients Whose Teacher Rating Scale Was Returned- by Feedback Call Participation | We calculated the percent of patient charts with evidence that a teacher rating scale was received by the clinician/practice during the intervention period, separately for intervention clinicians who did and did not participate in at least one performance feedback call. | Intervention Period (8 months) | 
| Implementation Outcome: Number of Clinicians Who Completed All 3 Educational Presentations | We assessed the proportion of clinicians randomized to the intervention group that completed all 3 educational presentations. | Intervention Period (8 months) | 
| Implementation Outcome: Number of Clinicians Who Used the Collaborative Consultation Component | We calculated the proportion of clinicians in the intervention group that posted in the online networking site which was used to facilitate collaborative consultation. | Intervention Period (8 months) | 
| Implementation Outcome: Number of Clinicians Who Participated in at Least One Performance Feedback Call | We calculated the proportion of clinicians in the intervention group who participated in at least one of the four performance feedback calls that were held during the study period. | Intervention Period (8 months) | 
| Implementation Outcome: Number of Clinicians Who Participated in All Intervention Components and Attested to Fulfilling MOC Requirements | We calculated the proportion of clinicians in the intervention group who completed all components of the intervention and attested to fulfilling MOC requirements. | Intervention Period (8 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Evidence-Based Practice, Provider Education