Addressing Racial Ethnic Disparities in Access to ADHD Services

Aims

Aim 1: Develop a culturally-adapted, mHealth-supported version of CLS for implementation in schools serving children from low-SES and ethnic/racial minority backgrounds. Using Community-Based Participatory Research strategies, we will (1) form a community advisory panel of key stakeholders to inform CLS adaptations; (2) adapt the content and structure of CLS and integrate mHealth technology to promote is usability and feasibility schools serving children from low-SES and ethnic/racial minority backgrounds; (3) pilot test the adapted CLS program’s usability and feasibility; and (4) make additional modifications to the program.

Aim 2: Gather feedback to inform future CLS adaptations for children from low-SES and ethnic/racial minority backgrounds living in rural settings. Based on the IM-Adapt framework, we will gather feedback from key stakeholders in Imperial County schools about the unique needs and existing capacities of their student population to inform CLS adaptations for rural schools serving children from low-SES and ethnic/racial minority families.

Aim 3: Evaluate the implementation of the adapted program and its impact on child outcomes. We will conduct a Hybrid Type 1 Cluster Randomized Control Trial evaluating the usability, feasibility, and acceptability of the adapted CLS program, as well as its impact on child outcomes compared to standard school services.

Purpose

Beginning as early as kindergarten, children with ADHD from low-SES and Black and Latino backgrounds are less likely than children from higher-SES and White backgrounds to be diagnosed and provided with ADHD services at school or in their communities. Practical and perceptual barriers contribute to these disparities. To reduce disparities in access to quality evidence-based services in these populations, we will use a Community-Based Participatory Research approach to partner with key stakeholders and adapt the content and structure of CLS and use mHealth technology to address barriers to accessing services. We will develop a culturally enhanced adaptation of CLS that is supported by mHealth technology and will test implementation outcomes and effectiveness in a Hybrid Type 1 Cluster Randomized Control Trial in 24 schools in San Diego County.

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 San Diego State University (PI: Dr. Miguel Villodas).

School Partners: The project will be conducted in partnership with 24 elementary schools in San Diego County, and in partnership with key stakeholders from Imperial County schools.