The American Academy of Pediatrics (AAP) has established a set of consensus guidelines for pediatricians to follow. These guidelines can be challenging to implement in typical community-based practices. Cincinnati Children's Hospital Medical Center (CCHMC) has developed a program called the ADHD Collaborative to promote the adoption of these guidelines among community pediatricians. The program focuses on modifying the office system using academic detailing and quality improvement (QI) methodology to accommodate prescribed practice changes. The ADHD Collaborative has been very successful at recruiting practices in the Greater Cincinnati area, changing practice behaviors, and sustaining these practice behaviors over time at minimal cost to the project and to the office practice. Now that sustainability and effectiveness have been established, the next step is to modify the ADHD Collaborative model to make it amenable to widespread dissemination. The primary goal of the proposed study is to modify the ADHD Collaborative intervention to make it transportable and then evaluate this version in terms of effectiveness, consumer satisfaction, and costs.. A transportable intervention is described that utilizes telehealth videoconferencing, a web portal, and long-distance data collection. Initially, three pediatric practices will be recruited to test and refine the distal intervention delivery methodology. Then, eight new pediatric practices will be randomly assigned to receive the distal intervention or to a control group (treatment as usual). Information about pediatric practice behavior will be collected at baseline, 6-months, and 1-year post- baseline. The study design will allow for a preliminary assessment of the feasibility and effectiveness of the distal intervention in terms of rates of evidence-based practice behaviors to patients, change in pediatrician attitudes, consumer satisfaction, and costs. Significance: The proposed research has high public health significance since it addresses a core issue in community mental health delivery, the promotion of evidence-based care to children. This research proposes an innovative set of intervention techniques that will allow the delivery of an effective intervention model to a greater number and more geographically diverse set of pediatric practices than is currently feasible using existing methods.
A quality improvement program has been developed and tested by the PI that promotes the adoption of evidence-based practices among community pediatricians. The program focuses on modifying the office system using academic detailing and quality improvement (QI) methodology to accommodate prescribed physician practice changes. Modes of disseminating this tested intervention to a geographically diverse audience will be evaluated by the proposed research. ? ? ? ?
| Epstein, Jeffery N; Langberg, Joshua M; Lichtenstein, Philip K et al. (2013) The myADHDportal.com Improvement Program: An innovative quality improvement intervention for improving the quality of ADHD care among community-based pediatricians. Clin Pract Pediatr Psychol 1:55-67 |
| Garner, Annie A; O?connor, Briannon C; Narad, Megan E et al. (2013) The relationship between ADHD symptom dimensions, clinical correlates, and functional impairments. J Dev Behav Pediatr 34:469-77 |
| Epstein, Jeffery N (2012) How can the internet help improve community-based pediatric ADHD care? Expert Rev Neurother 12:501-3 |
| Epstein, Jeffery N; Langberg, Joshua M; Lichtenstein, Philip K et al. (2011) Use of an Internet portal to improve community-based pediatric ADHD care: a cluster randomized trial. Pediatrics 128:e1201-8 |
