Children's Attention Deficit Disorder With Hyperactivity (ADHD) Telemental Health Treatment Study (CATTS)
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While telemental health (TMH) programs are increasing nationally to address the inequity of access to psychiatric services, there are few reports of their efficacy, particularly with children. The current proposal will complete the second stage of our program development. In the first stage, we established the feasibility of a TMH service and its acceptability to families and PCPs. In the second stage of program development we will conduct a randomized clinical trial (RCT) that will determine whether it is possible to use technological advances to: 1) improve clinical outcomes for children with ADHD over outcomes achieved in usual PC; and 2) adhere to an EBT protocol implemented through TMH. Future studies will examine whether other types of complicated psychiatric disorders and EBTs are amenable to delivery via TMH.
The overall goal of this study is to determine whether an evidence-based model of care can be faithfully implemented when delivered using TMH to children with ADHD living in rural areas and can improve outcomes over treatment as usual (TAU) in PC. ADHD is an excellent focus for assessment of TMH, as PCPs encounter this disorder frequently, EBT guidelines are available, pharmacotherapy is the core treatment and is easily delivered in PC through videoconferencing, and stabilization may be readily achieved for most youth.
Condition | Intervention |
---|---|
Attention Deficit Disorder With Hyperactivity |
Other: CATMH intervention |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Health Services Research |
Official Title: | Telemental Health to Improve Mental Health Care and Outcomes for Children in Underserved Areas |
- Assess whether using a telemental health service delivery model effects improvement in children diagnosed with ADHD including decreased symptoms of inattention, hyperactivity, opposition and defiance and improved adaptive functioning. [ Time Frame: baseline, 4-, 10-, 19-, and 25-weeks ] [ Designated as safety issue: No ]
- Assess whether using a telemental health service delivery model improves the well-being of caregivers of children diagnosed with ADHD. [ Time Frame: baseline, 4-, 10-, 19- and 25-weeks ] [ Designated as safety issue: No ]
- Assess the ability of a telemental health service delivery model to improve treatment adherence in families of children with ADHD. [ Time Frame: baseline, 4-, 10-, 19- and 25-weeks ] [ Designated as safety issue: No ]
- Assess how reliably an evidence-based treatment protocol for the treatment of children with ADHD can be implemented within a brief telemental health service. [ Time Frame: baseline, 4-, 10-, 19-, and 25-weeks ] [ Designated as safety issue: No ]
Estimated Enrollment: | 250 |
Study Start Date: | September 2009 |
Estimated Study Completion Date: | May 2013 |
Estimated Primary Completion Date: | January 2013 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: CATMH intervention
Child telemental health service delivery intervention
|
Other: CATMH intervention
This intervention is comprised of 6-tandem-sessions of pharmacotherapy and a behavioral intervention conducted over 4-5 months. The telepsychiatrist makes prescribing decisions during the intervention following consensus guidelines for ADHD treatment. The telepsychiatrist also provides education about how neurobiological deficits of ADHD relate to observed behavioral learning and difficulties. After the 6th session, the PCP resumes care of the patient. The behavioral intervention component is delivered by therapists at each participating clinic. The therapists are trained and supervised remotely by a telepsychologist . The 6-session behavioral intervention consists of approaches to managing children's behaviors and coordination with schools and other community agencies to advocate for the child.
Other Name: Childrens' Telemental Health Service
|
No Intervention: augmented TAU/PCP
Augmented treatment as usual with primary care physician
|
Ages Eligible for Study: | 5 Years to 12 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- is 5.5 - 12 years of age
- resides at home with parents/relatives
- has a dx of ADHD (CBCL DSM-oriented elevation or previous diagnosis of ADHD; C-DISC diagnosis)
- attends school 80% of time or more (including home-schooled children)
- speaks English or Spanish and parent speaks English or Spanish
Exclusion Criteria:
- child has a diagnosis of: CD, OCD, psychosis, BPD, Autism, mental retardation, major medical illness
- resident parent has a drug use problem
Contact: Kathleen M Myers, MD, MPH, MS | 206-987-1663 | kathleen.myers@seattlechildrens.org |
Contact: Heather D Violette, PhD | 206-884-8259 | heather.violette@seattlechildrens.org |
United States, Washington | |
Seattle Children's Hospital | Recruiting |
Seattle, Washington, United States, 98105 | |
Contact: Kathleen M Myers, MD, MPH, MS 206-987-1663 kathleen.myers@seattlechildrens.org | |
Contact: Heather D Violette, PhD 206-884-8259 heather.violette@seattlechildrens.org | |
Principal Investigator: Kathleen Myers, MD, MPH, MS |
Principal Investigator: | Kathleen Myers, MD, MPH, MS | Children's Hospital and Regional Medical Center |
Study Director: | Ann Vander Stoep, PhD | University of Washington |
Study Director: | Elizabeth McCauley, PhD | University of Washington; Children's Hospital and Regional Medical Center |
Study Director: | Wayne Katon, MD | University of Washington |
Study Director: | Carolyn McCarty, PhD | University of Washington |
No publications provided
Responsible Party: | Kathleen Myers, Principal Investigator, Seattle Children's Hospital |
ClinicalTrials.gov Identifier: | NCT00830700 History of Changes |
Other Study ID Numbers: | 12537, R01MH081997 NIMH |
Study First Received: | January 27, 2009 |
Last Updated: | April 24, 2012 |
Health Authority: | United States: Institutional Review Board |
Keywords provided by Seattle Children's Hospital:
ADHD telemental health TMH telepsychiatry rural mental health services for children |
Additional relevant MeSH terms:
Attention Deficit Disorder with Hyperactivity Hyperkinesis Attention Deficit and Disruptive Behavior Disorders Mental Disorders Diagnosed in Childhood Mental Disorders |
Dyskinesias Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on October 18, 2012