Collaborative Life Skills Digital Mental Health Project (CLS-D)

Aims

Aim 1: Develop a mobile health-supported adaptation of CLS (CLS-D) for implementation in  schools with limited resources that serve low-SES students. Based on a user-centered design  approach, we will engage panels of key stakeholders, including SMHPs, teachers, students with  ADHD from low-SES families, and their parents to inform the iterative (1) adaptation of CLS  content and structure to fit the target school settings, and (2) development of a mHealth prototype  designed to support CLS implementation. We will also adapt CLS training and fidelity monitoring  protocols, and cost evaluation tools to fit the adapted model.  

Aim 2: Test the usability, feasibility, and acceptability of CLS-D among SMHPs, teachers,  parents, and students. We will conduct a series of usability tests with stakeholder panels to  inform the refinement of the dHealth prototype. We will then conduct open trials of CLS-D at each  site, followed by focus groups with participants to assess whether it is usable, can be feasibly  implemented, is perceived favorably, and results in improved student outcomes. We will refine  CLS-D, including the mHealth prototype, training and fidelity monitoring protocols, and cost  evaluation tools throughout these trials, as needed.  

Aim 3: Evaluate the feasibility and impact of CLS-D on student outcomes relative to typical  school services. We will conduct a randomized pilot trial comparing CLS-D to business as usual  (BAU) to determine if it can be implemented with fidelity, estimate the costs and resources needed  to support its implementation, and evaluate its effects on proximal and sustained educational  outcomes in schools with limited resources serving students from low-SES backgrounds.  

Purpose

Existing evidence-based interventions for students with ADHD are often inaccessible in schools with limited resources to support their implementation. Barriers to accessing ADHD services disproportionately affect students from low-SES backgrounds. To improve access to these needed services, the proposed project aims to develop an adaptation of the Collaborative Life Skills Program (CLS)  that will be supported by a digital health tool to improve the feasibility of its implementation in schools with limited resources. We will employ a user-centered design approach to iteratively develop, refine, and evaluate a mobile health (mHealth) app with the end-users in mind. This approach will involve focus groups with key stakeholders (i.e., end-users), the development of a prototype, usability testing, and open feasibility trials in four schools. We will then evaluate the usability, feasibility, acceptability, and impact of CLS-D, relative to business as usual (BAU) in a pilot randomized trial in 12 schools from the Vista Unified and Oakland Unified School Districts.

The Collaborative Life Skills Program (CLS) is an empirically-supported, school-based intervention for children who struggle with regulating their attention and behavior at school and home. CLS was designed by Dr. Linda Pfiffner and her team of researchers at UCSF in collaboration with the San Francisco Unified School District (SFUSD). CLS was designed for implementation by school mental health professionals who coordinate three components with teachers, parents and students: 1) behavioral classroom interventions, 2) behavioral parent interventions, and 3) student skills groups. The effectiveness of CLS on student success has supported by several clinical trials in SFUSD, as well as schools in Sinaloa, Mexico. For more information about CLS, please visit https://psych.ucsf.edu/HALP/research/CLS. 

Sites:  The study will be carried out at two sites: San Diego State University (PI: Dr. Miguel Villodas) and the University of California, San Francisco (PI: Dr. Linda Pfiffner).

School Partners: The project will be conducted in partnership with 24 elementary schools in the Vista Unified and Oakland Unified School Districts.