Symposia
ADHD - Child
Lauren M. Haack, Ph.D.
Associate Professor
University of California San Francisco
San Francisco, California
Jasmine Lai, BS
Research Assistant
University of California, San Francisco
San Francisco, California
María Fernanda Arriaga Guerrero, Psic.
Clinical Research Coordinator
Autonomous University of Sinaloa
Culiacán,, Sinaloa, Mexico
Maria Elena Urquidez Valdez, PhD
Research Professor
University of Sinaloa
Culiacan, Sinaloa, Mexico
Dulce Karely Alcaraz Beltrán, Lic.
Program Trainer
University of Sinaloa
Culiacan, Sinaloa, Mexico
Evelyn Clarissa Zúñiga Rivera, MC
Program Trainer
University of Sinaloa
Culiacan, Sinaloa, Mexico
Dulce Maria Ledesma Saldaña, Profa.
Program Trainer
University of Sinaloa
Culiacan, Sinaloa, Mexico
Korinthya Delgado García, Profa.
Program Trainer
University of Sinaloa
Culiacan, Sinaloa, Mexico
Elva Moreno Candil, Profa.
Information Technology Associate Professor
University of Sinaloa
Culiacan, Sinaloa, Mexico
Jassiel Ulises Martinez Beltran, RC
research Coordinator
University of Sinaloa
Culiacan, Sinaloa, Mexico
Eva A. Araujo, PhD
Research Professor
University of Sinaloa
Culiacan, Sinaloa, Mexico
Introduction: An efficacious and feasible solution to treating ADHD on a global scale is training school clinicians to deliver evidence-based interventions with fidelity. Promising results of such efforts have occurred in settings with high unmet need, such as Mexico. Converting programs for remote delivery allows for more accessibility and scalability than in-person options.
Method: We adapted a comprehensive intervention and Mexican school clinician training program (i.e., CLS-FUERTE) for remote delivery (i.e., CLS-R-FUERTE). A total of N = 18-24 youth with ADHD symptoms will participate in a three-school CLS-R-FUERTE open-trial (n = 6-8 youth/school) during the 2021-2022 school year. Parents and teachers provide baseline ADHD ratings and school clinicians are tested on evidence-based practice skills. Next, we remotely train school clinicians and monitor fidelity and acceptability during the 6-week program implementation; we then collect post ratings and conduct interviews/focus groups. We employ a rapid qualitative approach to derive meaningful themes from observation and feedback, guiding iterative program changes between each school cohort.
Results: To date, we have implemented/evaluated CLS-R-FUERTE in one school cohort and made one round of iterative changes. The school clinician attended 100% of training sessions and implemented 100% of intervention components with fidelity reaching ‘effective’ or ‘highly effective’ quality ratings. Attendance ranged from 42-100% in parent and student groups; parents reported applying the program skills ‘less than half of the time’ to ‘almost every day.’ School clinician and parent satisfaction ratings ranged from ‘more or less’ to ‘extremely’ satisfied. Meaningful themes emerged from observation and feedback which guided iterative program changes.
Conclusion/
Discussion: Remote delivery of comprehensive ADHD intervention and school clinician training in Mexico appears feasible and acceptable. Some challenges arose in the context of technological barriers (e.g., internet connectivity issues), remote group engagement, and evolving shelter-in-place guidelines as the COVID-19 pandemic conditions improved and later surged. In response, the inclusion of technology specialists on the team, as well as flexibility in applying adaptations to methodology when needed, were valuable. Next steps include implementing and evaluating the iteratively-adapted CLS-R-FUERTE program in an eight-school clustered Randomized Controlled Trial during the 2022-2023 school year.