Enhancing behavioral parent training for parents and children affected by ADHD - PROJECT SUMMARY/ABSTRACT Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most common mental health conditions in childhood, and nearly half of all youth with ADHD have at least one parent who also meets criteria for the disorder. Intergenerational ADHD is a significant risk factor for reduced skill use and poor child outcomes following evidence-based behavioral parent training (BPT) programs. Given that BPT is predicated on consistent, in vivo use of BPT skills, efforts to reduce parental ADHD-related barriers to BPT skill use may have significant public health implications. Incorporating Cognitive and Behavioral Therapy (CBT) strategies shown to improve adult ADHD symptoms and executive dysfunction into BPT programs may reduce such barriers. Mobile health (mHealth) adjunct interventions are another promising approach to improve BPT skill use, as personalized CBT-based supports and temporally relevant reminders may also reduce several of the most common barriers. Yet, no existing BPT program includes these augmentations. This K23 seeks to adapt an evidence-based BPT program to reduce skill use barriers and increase skill use among parents with ADHD by incorporating (a) in-session modules on adult ADHD CBT strategies and (b) a smartphone-based app that provides timely reminders and CBT-based supports. The intervention, Executive Function Enhanced Caregiver Training Skills (EFECTS), will be developed using an iterative, stakeholder driven approach that uses Human Centered Design (HCD) strategies to incorporate end-user feedback at all stages of development to improve fit, outcomes, and implementation. A pilot RCT will compare EFECTS to an existing BPT program. Candidate: My early research examined the underlying executive function deficits associated with ADHD, and my long-term career goal is to design theory-driven interventions based on our understanding of the etiological underpinnings of the disorder. As treatment research represents a shift in my research interests, I require formal, mentored training in intervention design and evaluation. Through this mentored career development award, I will learn the skills necessary to become an independent intervention researcher, including 1) mechanism-focused intervention development, 2) mHealth applications to improve parenting intervention skill use, and 3) methods to improve intervention fit, implementation, dissemination, and effects. My mentorship team is well-suited to provide the training necessary for me to become a successful intervention researcher and consists of Dr. Sharlene Wolchik (primary mentor; expertise: theory-based parenting intervention development; RCT implementation), Dr. Linda Pfiffner (co-primary mentor; expertise: developing BPT programs for ADHD), Dr. Mary Solanto (co-mentor; expertise: designing CBT interventions for adults with ADHD and executive dysfunction), Dr. David MacKinnon (advisor; expertise: analyzing treatment mechanisms and outcomes), Dr. Aaron Lyon (advisor; expertise: HCD, implementation science), and Dr. Oliver Lindhiem (advisor; expertise: parenting skill use assessment, digital health interventions).
