PROJECT SUMMARY/ABSTRACT
While evidence-based behavioral treatments for adolescents with Attention-Deficit/Hyperactivity Disorder
(ADHD) are well-established, these interventions most often fail to generalize across settings and are
associated with intervention effects that dissipate over time. The current proposal takes a theory-driven,
empirical approach for optimizing existing behavioral treatment by targeting adolescents’ skills utilization and
engaging other modifiable factors associated with trajectories of ADHD-related impairment including reward
sensitivity, motivation, executive functioning, and social support. Mobile technologies offer transformative
opportunities for engaging these targets and overcoming the notorious challenges impeding treatment
adherence for adolescents with ADHD. This mentored K23 award will support the candidate in developing an
independent research career investigating innovative approaches for optimizing treatment response for youth
with ADHD. This K23 is designed to provide the necessary training to become an expert in leveraging
technology-enhanced resources to target behavioral skill utilization in order to enhance treatment response
and promote sustained improvement. This award will provide the candidate with advanced training in: (1)
interactive health technologies; (2) adherence promotion; (3) methods and statistical approaches for ecological
valid, real time assessment and adaptive intervention designs; and (4) mechanism-based intervention
refinement and evaluation; and (5) grant writing skills and research dissemination. Through the University of
California, San Francisco (USCF) Laboratory for Hyperactivity, Attention, and Learning Problems (HALP) and
the UCSF’s Clinical and Translational Science Institute (CTSI) Award, the candidate is uniquely equipped with
resources to achieve her training objectives and complete this research. The mentorship team includes senior
level investigators with active federally-funded research, experience mentoring early-career investigators, and
expertise in: implementing persuasive technology for adherence and behavior change (Lyles), user-centered
design, development, and evaluation with adolescents (Ozer), human-computer interaction and gamification
(Gazzaley), ecological skills assessment (Lindhiem), adaptive intervention designs with digital tools (Murphy),
and mechanisms underlying interventions (Pfiffner; HALP Director, primary mentor). Applying this training, the
proposed research will use an iterative stakeholder-centered design to develop, refine, and preliminarily test a
scalable digital health tool, applied as an adjunct to behavioral treatment for adolescents with ADHD (ages 11-
14). Following usability testing to guide refinements, a small pilot RCT (N=60) will examine target engagement
and validation (skills utilization) for promoting enhanced and evaluate the feasibility of this novel tool when
integrated with treatment delivery. The training, mentorship, and research supported by this K23 will facilitate
the candidate in designing the next phase of this research, a large-scale adaptive intervention trial (R01) that
delivers personalized strategies to optimize treatment engagement and skills utilization in real time.