Children with ADHD are at significant risk for failing to complete high school and as many as 25 percent develop chronic patterns of antisocial behavior that persist into adulthood. Primary care providers--the practitioners who evaluate and treat the vast majority of children with ADHD--often fail to utilize systematic and empirically based procedures to guide their evaluation and treatment decisions. The goal of the proposed research is to assess the feasibility of using a media support package to aid community-based pediatricians in their implementation of proven intervention techniques. Given the limited time physicians (and other health care professionals) can provide to each family, such tools are essential for informed patient families and effective clinical practice -- and do not presently exist. The three primary content areas are: 1) Diagnosis and Assessment; 2) Titration Trials; and 3) Medication Maintenance. In phase I, all three components will be designed and the second will be fully produced as a videotape prototype. Phase II will produce the remaining sections as video and adapt the content for delivery as a web-enhanced CD-ROM. Evaluation will be conducted in two stages: (1) formative evaluation throughout the design process as represented by expert and end-user reviews of several stages of the prototype and (2) a field-trial of the materials involving their dissemination to approximately 100 patient-families in an NIMH-funded study of the efficacy of a university-based assistive infrastructure for supporting pediatricians in caring for children with ADHD, Measures include affective, cognitive and behavioral indices: (1) parent and pediatrician perceptions of the product's usefulness and usability, (2) parent comprehension fostered by the product and (3) parent and pediatrician compliance with effective clinical practice.
The potential market for the proposed set of media aides is quite large. They will be used by a variety of health care providers, including psychiatrists, pediatricians, and family practitioners, all of whomprovide care for ADHD children. Among pediatricians alone, there are approximately 30,000 practicing pediatricians in the U.S. today. Health providers will be encouraged to purchase at least one videotape for their office practice in the U.S. today. Health provider will be encouraged to purchase at least one videotape for their office practice which could be shown to parents either in the office or parents could be allowed to take the videotapes home to view it at their leisure to be returned at a later date. The booklets that accompany the videotapes will be purchased in bulk by the health practitioners to be given to/purchased by parents. Direct sales to parents represents an additional market. Several pharmaceutical companies are in the process of packaging ADHD medications in such a way that facilitates titration methodology. Once packaging is completed by the pharmaceutical companies, they will then market their product using their own representatives, advertising, and letters to health care providers. The currently proposed media support package will be marketed to these pharmaceutical companies to be sold or packaged with their newly packaged medications. Such interest is documented in this application.
