Adaptation and Usability of Community Reinforcement and Family Training (CRAFT) for ADHD - PROJECT SUMMARY/ABSTRACT Attention-Deficit/Hyperactivity Disorder (ADHD) is chronic and requires specific attention toward treatment disengagement at critical transition points (e.g., transition to adulthood) due to the steep reduction of parental and institutional supports. Left untreated, transition-age youth with ADHD are at risk for anxiety, depression, substance use, poor educational/vocational attainment, and suicide, resulting in medical, emotional, and financial costs to parents. Thus, there is a need to equip parents to effectively engage their youth with ADHD in treatment during this critical transition period (i.e., balance support and youth independence in a manner that does not further increase disengagement). Currently, no existing treatments directly target disengagement for transition-age youth with ADHD. The Community Reinforcement and Family Training (CRAFT) approach is an evidence-based behavioral treatment that works directly with concerned significant others (CSOs) of loved ones with substance use disorders to engage in treatment. Based on core components that focus on effective communication, operant conditioning/learning, and CSO’s own mental health, CRAFT has clear relevance for addressing ADHD-related executive functioning deficits (e.g., planning, goal persistence, procrastination) exacerbated by increased environmental demands for transition-age youth. The purpose of this study is to address the needs of disengaged transition-age youth with ADHD and their parents by adapting an intervention to support parents to effectively engage their youth into care through focus groups/interviews with parents, providers, and transition-age youth. This study also aims to recruit from local community college and university campuses, and community-based organizations, and engage members of the community through forums to provide feedback on focus group findings. Involving families and providers at the onset of adaption to explore feasibility and acceptability increases the potential for this intervention to be implemented and sustained in the future. Specific aims include: 1) Iteratively modify CRAFT to increase relevance to parents of disengaged transition-age youth with ADHD (CRAFT-ADHD) using 4-6 focus groups/qualitative interviews with up to a total of n=25 parents, n=15 providers, and n=10 transition-age youth, and 2) conduct usability testing of telehealth CRAFT-ADHD for parents (n=10) to assess feasibility and acceptability, and define potential targets of action at the individual and family level. Through community-engaged recruitment efforts and community forums, this study aligns with NIMH’s priority 4 to “advance implementation research to improve access to, and utilization of, quality care among underserved, underrepresented, and under-resourced populations by emphasizing community-based interventions and incorporating multilevel decision-making perspectives.” The long-term goal is to use the developed protocols and materials to 1) conduct future studies on efficacy and effectiveness testing of CRAFT-ADHD on identified target outcomes, and 2) test larger-scale effective implementation work in usual care settings.
