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Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income Children

Award Number: K23MH118478
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/21/2018
PERIOD OF PERFORMANCE END DATE: 06/30/2025

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Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income Children - PROJECT SUMMARY. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common chronic conditions in childhood, with significantly higher rates and worse outcomes among socioeconomically disadvantaged children. Social adversities including unmet basic needs such as food insecurity, housing instability, and lack of quality child care emerge as potent risk factors for ADHD symptoms as early as the preschool years. The development of early intervention strategies for young children with both ADHD and socioeconomic disadvantage is critical for mitigating future impairment. New research demonstrates that a low intensity, family-centered screening and referral program (WE CARE) at well infant visits is feasible and can increase receipt of resources for unmet social needs (e.g. food, transportation, and parent education). Adapting this strategy to target preschoolers with emerging ADHD, who are typically first identified in primary care, could significantly impact clinical symptoms and disease trajectory during a critical developmental period. Therefore, the objective of this project is develop an early intervention strategy, adapted from the WE CARE program, targeting unmet social needs for low-income families of preschool-age children with emerging ADHD. The WE CARE intervention will be adapted on 3 key domains (for a new target population, content, and primary outcomes) through the pursuit of 3 interrelated studies. These are: 1) Examine the association between specific unmet social needs and ADHD symptoms in 7,565 nationally representative children age 3-5 from the National Survey for Children's Health (NSCH) and explore potential mediators of this association (including parental stress, activation, and unmet need for care) via structural equation modeling (SEM); 2) Identify parent-reported mechanisms by which unmet social needs exacerbate ADHD symptoms in preschool age children and how an intervention addressing these needs could improve clinical outcomes by conducting semi-structured interviews with 25 parents of preschoolers with ADHD symptoms; and 3) Conduct an adaptive, randomized pilot trial of a novel treatment model addressing unmet social needs with parents of 60 low-income children age 3-5 with ADHD symptoms. This research plan reflects Objective 3.2 of the NIMH Strategic Plan, to develop ways to tailor existing and new interventions to optimize outcomes, and addresses an urgent need to reduce socioeconomic disparities in pediatric mental health outcomes by targeting modifiable risk factors in vulnerable young children. These research aims will also serve as vehicles for pragmatic learning of the following training goals: 1) Learn advanced statistical modeling and measurement methods for social determinants research; 2) Gain expertise in intervention development to reduce mental health disparities; and 3) Obtain training in modern clinical trial design for the study of psychosocial and health services interventions. This mentored K23 award will facilitate Dr. Spencer's long-term goal of becoming an independent investigator developing novel interventions to reduce socioeconomic inequities in pediatric psychiatric outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	001	4	1/14/2025	SUPPLEMENT FOR EXPANSION	-$1
2025	2021	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Mental Health Research Grants	002	5	1/14/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$1,545
2025	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	4	1/14/2025	NON-COMPETING CONTINUATION	-$1,544
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2021	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Mental Health Research Grants	000	5	7/11/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = -$7,033 )
2023	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	001	4	6/26/2023	SUPPLEMENT FOR EXPANSION	-$56,339
2023	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	4	6/26/2023	NON-COMPETING CONTINUATION	-$59,234
2023	2021	ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO	225 E CHICAGO AVE	CHICAGO	IL	60611	COOK	USA	Mental Health Research Grants	002	5	6/26/2023	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$108,540
														Subtotal = -$7,033

Issue Date FY: 2022 ( Subtotal = $56,340 )
2022	2022	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	4	7/18/2022	SUPPLEMENT FOR EXPANSION	$56,340
														Subtotal = $56,340

Issue Date FY: 2021 ( Subtotal = $159,986 )
2021	2021	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CTR PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	4	9/2/2021	NON-COMPETING CONTINUATION	$159,986
														Subtotal = $159,986

Issue Date FY: 2020 ( Subtotal = $163,137 )
2020	2020	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	001	3	9/4/2020	NON-COMPETING CONTINUATION	$163,137
2020	2019	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	2	11/5/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $163,137

Issue Date FY: 2019 ( Subtotal = $164,094 )
2019	2019	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	001	2	8/30/2019	NON-COMPETING CONTINUATION	$164,094
2019	2018	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	1	11/5/2018	NEW	$0
														Subtotal = $164,094

Issue Date FY: 2018 ( Subtotal = $159,384 )
2018	2018	BOSTON MEDICAL CENTER CORPORATION	1 BOSTON MEDICAL CENTER PL STE 1	BOSTON	MA	02118	SUFFOLK	USA	Mental Health Research Grants	000	1	9/21/2018	NEW	$159,384
														Subtotal = $159,384

Grand Total All Awards = $695,908

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Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income Children

Award Number: K23MH118478

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/21/2018

PERIOD OF PERFORMANCE END DATE: 06/30/2025

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