PROJECT SUMMARY/ABSTRACT
I am a developmental-behavioral pediatrician who has earned an MS in Clinical Research. My long-term goal
is to become an independent researcher focused on advancing developmental-behavioral outcomes of
children from diverse, underserved groups by improving their adherence to treatment plans for mental health
conditions, including attention-deficit hyperactivity disorder (ADHD). My current objective, which represents the
next step in pursuit of this goal, is to develop a culturally-tailored family navigator Intervention to Improve
ADHD-Related Treatment adherence (I2-ART) for minority children using a systematic, patient-centered,
iterative approach consistent with the ORBIT model for behavioral intervention development. Key elements of
the career development plan to support both my long-term goal and current objective include training in (1) the
design and evaluation of clinical and mental health services trials to improve treatment adherence, (2) health
disparities and community-partnered research, and (3) effective grant and manuscript writing. My mentorship
team includes NIH-funded investigators with expertise in ADHD, clinical trial design, treatment adherence,
health disparities, and community-partnership research. Furthermore, Cincinnati Children’s Hospital, which
ranks #2 among U.S. children’s hospitals for NIH funding, provides an outstanding research environment and
strong support for junior faculty, including >30 current recipients of NIH Career Development Awards.
Proposed Research: ADHD is the most common pediatric neurodevelopmental disorder and is associated with
significant long-term impairments. Current guidelines recommend stimulant medication and/or behavioral
therapy as first-line treatments for ADHD. Despite evidence that consistent treatment is important for effectively
managing ADHD symptoms, treatment adherence remains suboptimal and is especially problematic among
minority children. Hypothesized reasons for racial/ethnic disparities in ADHD treatment include uncertainties
about medication efficacy and side effects, distrust of the health care system, and decreased access to mental
health services. This study aims to develop and test the I2-ART intervention to improve treatment adherence in
minority (Latinx and African American) children with ADHD. The proposed study involves three ORBIT phases:
During phase 1a, we will conduct focus groups with key stakeholders (i.e., caregivers, clinicians, and family
navigators, n=24) to identify and develop I2-ART’s basic elements. Next, during phase 1b, we will train four
family navigators to implement I2-ART with caregivers of treatment-naïve children with ADHD (n=8-12) in order
to determine feasibility and acceptability. In phase 2, we will use phase 1b findings to modify I2-ART as
needed, and then will evaluate the preliminary efficacy of the revised I2-ART (n=40), compared to the “usual
care” control condition (n=20), on ADHD treatment adherence. The preliminary data collected during the
proposed study will inform a subsequent R01 randomized controlled trial to examine I2-ART efficacy.