Attention deficit hyperactivity disorder (ADHD) affects 8% of US youth. Even though evidence shows medications are effective in reducing ADHD symptoms, many families experience ongoing parenting stress around parent-child interactions. Children often have ongoing impairments in functioning. ADHD is a common condition identified and managed by primary care pediatricians. However current care in the clinic is not optimal to address parents' and children's needs around ADHD chronic care. Time is the biggest barrier. Group visits are a viable option to improve pediatric ADHD care, but requires extensive study. The goal of this proposed study is to test the feasibility and effectiveness of the group visit model for ADHD management within pediatric primary care. This study will be a randomized feasibility study that will generate important pilot data, as well as result in an innovative, exportable pediatric ADHD group curriculum for primary care practice.
The specific research aims of this proposal are: Aim 1: Develop and test a group curriculum for parents of children (age 6 to 18 years) with ADHD to increase parental knowledge about ADHD and self-confidence in managing issues related to their child's functioning in school and home. Aim 2: Develop and test a group curriculum for children (age 6 to 18 years) with ADHD to teach social and educational skills to improve adaptive functioning at home and school. Aim 3: To assess any added benefits to the parents, children and providers (related to group visit logistics and satisfaction) the group visit model has over usual care. Aim 4: To assess whether the group visit model can be done efficiently and effectively in the setting of an actual general pediatric practice.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
56
Study specific ADHD Group curriculum was designed and implemented for the study. Parent curriculum included the following topics: What is ADHD, medications, educational advocacy, how to prevent behavioral issues and how to defuse common behavioral challenges and manage stress. Child curriculum included the following topics: what is ADHD, social skills and friendships, handling school and organization skills, understanding feelings and managing negative emotions
General Pediatrics Clinic Medical Service Area 1 in Riley Hospital for Children at IU Health
Indianapolis, Indiana, United States
Number of clinic visits during study period
Feasibility of group visit model was measured as number of visits to the clinic by chart review. We also looked at the number of group visits a family attended based on the sign in sheet provided at the beginning of each session.
Time frame: 12 months
Parent-rated ADHD symptoms
Parents completed validated Vanderbilt Rating Scale regarding child's ADHD symptoms. Measures response to ADHD treatment, primarily medication.
Time frame: Baseline
Parent-rated ADHD symptoms
Parents complete validated Vanderbilt Rating Scale to report child symptoms of ADHD. Used to assess response to treatment, usually medication.
Time frame: 12 months
Child functioning at home
Parent report of adaptive functioning of child in the home setting using the Home Situations Questionnaire
Time frame: Baseline
Child functioning at home
Parents report of child's adaptive functioning in the home setting using the Home Situations Questionnaire.
Time frame: 12 months
Teacher report of child's ADHD symptoms
teachers received the validated Vanderbilt rating scale to rate student's ADHD symptoms in the classroom. Parents were given the tool at time of enrollment and asked to give to teacher as per clinical care guidelines. Monitors impact of ADHD treatment, usually medication.
Time frame: baseline
teacher report of child's ADHD symptoms in school
teachers received the validated Vanderbilt rating scale to rate student's ADHD symptoms in the classroom. Parents were given the tool at time of enrollment and asked to give to teacher as per clinical care guidelines. Monitors impact of ADHD treatment, usually medication.
Time frame: 12 months
Child functioning at school
teachers were invited to provide rating of child's adaptive functioning at school. Parent given the tool at time of enrollment and instructed to give to teacher as per clinical care guidelines.
Time frame: baseline
teacher rating of child's functioning in school
teachers were invited to provide rating of child's adaptive functioning at school. Parent given the tool at time of enrollment and instructed to give to teacher as per clinical care guidelines.
Time frame: 12 months
Quality of Life
Capture parent rating of quality of life related to ADHD using the Child Health Questionnaire-28 validated tool.
Time frame: baseline
Quality of Life
Capture parent rating of quality of life related to ADHD using the Child Health Questionnaire-28 validated tool.
Time frame: 12 months
Parenting self-efficacy
Parent reported sense of confidence using the Parenting Sense of Confidence Scale
Time frame: Baseline
Parenting Self-efficacy
Parent-reported sense of confidence using Parenting Sense of Confidence scale
Time frame: 12 months
Parental knowledge, satisfaction towards medication treatment
Parent report of knowledge, attitudes and satisfaction towards medication experiences with ADHD medication treatment
Time frame: baseline
Parent knowledge and satisfaction towards medication treatment
Parent report of knowledge, attitudes and satisfaction towards medication experiences with ADHD medication treatment
Time frame: 12 months
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