Digital Health Intervention for Children with ADHD: Improving Mental Health Intervention, Patient Experiences, and Outcomes
Expansion of an evidence-based digital health intervention for attention deficit hyperactivity disorder in children that is focused on improving communication and care coordination across multiple points of care has the potential to improve outcomes for this group of individuals.
Project Details -
Ongoing
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Grant NumberR21 HS028871
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AHRQ Funded Amount$1,022,295
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Principal Investigator(s)
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Organization
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LocationRiversideCalifornia
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Project Dates09/30/2022 - 09/29/2027
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Technology
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Care Setting
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Medical Condition
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Type of Care
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Health Care Theme
Attention deficit hyperactivity disorder (ADHD), the most prevalent psychiatric condition in children, has profound public health, personal, and family impacts. As a condition that lasts a lifetime, maintenance and substantial self-regulation are required to support treatment gains, but long-term adherence to treatment is challenging. To be managed well, a multidisciplinary approach must be adopted that includes primary care and mental health clinics, as well as support at home and in school. Without an organized method to ensure information sharing between these various touch points, treatment becomes less targeted and effective: lack of communication and integration across the aspects of care represents a barrier to effective treatment. Providing support and reinforcement with an evidence-based digital health intervention (DHI) technology integrated into a smartwatch and smartphone may be one mechanism to improve outcomes.
In previous AHRQ-funded research, the researchers developed and piloted a DHI called CoolCraig, a wearable and connected system combining a smartwatch, mobile phone application, and web portal that delivers, reinforces, and sustains treatment for adolescents with ADHD. That research showed that the DHI could support self-regulation in children but revealed a need for improved coordination across the multiple points of care. This research will adapt CoolCraig by adding features to improve quality of care and patient, parent, and provider outcomes, including improved patient regulation, improved access to timely, meaningful data for caregivers, and reduction in provider burden during patient visits. The expanded system is referred to as the CoolCraig+ParentCoach system, with CoolCraig as the smartwatch app for children, and ParentCoach an app used by parents in collaboration with teachers.
The specific aims of the research are as follows:
- Conduct interviews and participatory-design workshops.
- Conduct a proof-of-concept study.
- Conduct a randomized controlled trial (RCT) to evaluate the efficacy of the system.
At the start of this research, the team will conduct interviews and design workshops with psychiatrists, psychologists, pediatricians, educators, and children and their parents to identify, refine, and add features that support multiple points of care to the DHI. The researchers will investigate barriers to interventions for ADHD and the potential to improve communication and decision making at each point of care. User preference for input and output will be collected, and feedback will be obtained iteratively on new versions of the system as they are developed. The expanded DHI will then be used in a proof-of-concept study. The team will conduct interviews with children, parents, educators, and providers at 4, 8, 12, and 16 weeks on the system’s use, impact, user experiences, and outcomes to inform further design. Finally, the researchers will conduct a RCT to assess the impact of the intervention on the experiences and outcomes of the stakeholders.
The overall goal of this research is to revolutionize mental health interventions with a model for an evidence-based DHI that enhances and sustains mental health treatment for children with ADHD and thus improve access to effective management and treatment of this condition.
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