Evaluation of an Intervention for Improving Community-based Pediatric Attention-Deficit Hyperactivity Disorder (ADHD) Care
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Psychiatric, ADHD |
| Therapuetic Areas: | Psychiatry / Psychology, Other |
| Healthy: | No |
| Age Range: | 6 - 11 |
| Updated: | 4/21/2016 |
| Start Date: | May 2010 |
| End Date: | June 2016 |
Evaluation of an Intervention for Improving Community-based Pediatric ADHD Care
ADHD is the most prevalent mental health disorder of childhood. The majority of children
with ADHD receive their care in primary care settings. While the American Academy of
Pediatrics (AAP) issued evidence-based guidelines and recommendations for pediatricians,
most pediatricians have difficulty adhering to these guidelines. Given observed deficiencies
in evidence-based ADHD care and the likely effects on child outcomes, the development and
testing of interventions aimed at improving ADHD care in primary care settings is necessary.
Cincinnati Children's Hospital Medical Center has developed a model intervention, termed the
ADHD Collaborative, to comprehensively address this issue. The ADHD Collaborative
intervention model includes academic detailing, quality improvement methods, and innovative
tools (e.g., web portal) designed to promote and support the systematic use of the AAP
guidelines. This intervention model has been used to train over 200 physicians at 55
practices in the Greater Cincinnati area. The intervention appears to produce 2- to 4-fold
increases in the use of evidence-based ADHD-related practice behaviors in participating
physicians. To date, the intervention has been implemented as a quality improvement project
with few experimental controls. The primary goal of the proposed study is to conduct an
experimentally-controlled cluster randomized trial of the ADHD Collaborative intervention.
Thirty-two pediatric practices will be randomly assigned to receive the ADHD Collaborative
intervention or to provide usual care. Approximately 96 physicians and 576 of their ADHD
patients will be included in the study. Chart reviews, parental interviews, and parent and
teacher rating scales will be collected. Between- and within-group hierarchical linear
modeling analyses will examine whether the intervention produces significant improvements in
pediatrician practice behaviors, patient satisfaction with ADHD care, and child outcomes
over and above typical ADHD care. Also, the relative cost effectiveness of the ADHD
Collaborative intervention over typical care will be established by computing incremental
cost-effectiveness ratios using cost and effect size estimates.
with ADHD receive their care in primary care settings. While the American Academy of
Pediatrics (AAP) issued evidence-based guidelines and recommendations for pediatricians,
most pediatricians have difficulty adhering to these guidelines. Given observed deficiencies
in evidence-based ADHD care and the likely effects on child outcomes, the development and
testing of interventions aimed at improving ADHD care in primary care settings is necessary.
Cincinnati Children's Hospital Medical Center has developed a model intervention, termed the
ADHD Collaborative, to comprehensively address this issue. The ADHD Collaborative
intervention model includes academic detailing, quality improvement methods, and innovative
tools (e.g., web portal) designed to promote and support the systematic use of the AAP
guidelines. This intervention model has been used to train over 200 physicians at 55
practices in the Greater Cincinnati area. The intervention appears to produce 2- to 4-fold
increases in the use of evidence-based ADHD-related practice behaviors in participating
physicians. To date, the intervention has been implemented as a quality improvement project
with few experimental controls. The primary goal of the proposed study is to conduct an
experimentally-controlled cluster randomized trial of the ADHD Collaborative intervention.
Thirty-two pediatric practices will be randomly assigned to receive the ADHD Collaborative
intervention or to provide usual care. Approximately 96 physicians and 576 of their ADHD
patients will be included in the study. Chart reviews, parental interviews, and parent and
teacher rating scales will be collected. Between- and within-group hierarchical linear
modeling analyses will examine whether the intervention produces significant improvements in
pediatrician practice behaviors, patient satisfaction with ADHD care, and child outcomes
over and above typical ADHD care. Also, the relative cost effectiveness of the ADHD
Collaborative intervention over typical care will be established by computing incremental
cost-effectiveness ratios using cost and effect size estimates.
Inclusion Criteria:
- Practice must have a minimum of two pediatricians who agree to participate.
- Practice must have an electronic billing system.
- Practice must have internet access at office.
- Practice must not have an on-site mental health professional.
- Practice must have a member of practice staff willing to be trained in human subjects
certification and willing to consent families.
- Children must be in Grade 1-5.
- Children must be newly diagnosed with ADHD.
Exclusion Criteria:
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