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Published on: June 12, 2020
Guideline Development for Technological Interventions for Children and Young People to Self-Manage Attention Deficit
Lauren Powell1, Jack Parker1, Val Harpin2
1University of Sheffield, Sheffield, United Kingdom.
Insights
This study developed evidence-based guidelines for technology to help children and young people (CAYP) with Attention Deficit Hyperactivity Disorder (ADHD) self-manage their condition. These guidelines incorporate stakeholder input for effective intervention development.
Area of Science:
- Neurodevelopmental Disorders
- Digital Health Interventions
- Behavioral Science
Background:
- Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting individuals, families, and communities.
- Current ADHD management for Children and Young People (CAYP) often relies on external support rather than self-management strategies.
- Technological advancements offer potential for personalized ADHD self-management interventions in CAYP, but lack evidence-based guidelines.
Purpose of the Study:
- To create evidence-based guidelines for developing technological interventions.
- To facilitate the self-management of ADHD in CAYP.
- To provide recommendations through collaboration with key stakeholders.
Main Methods:
- A 5-phase realist evaluation (RE) approach was employed.
- Included identifying intervention propositions, behavior change theories, and context-mechanism-outcome configurations (CMOCs).
- Validated and refined propositions through interviews with CAYP with ADHD, parents, and clinicians.
Main Results:
- Seven key themes emerged: rewarding feedback, gaming resources, personalization, psychoeducation, integrated self-management, goal setting, and context.
- Identified mechanisms interacted with delivery contexts for complex technological interventions.
- Stakeholder input (clinicians, parents, CAYP) was crucial for refinement.
Conclusions:
- Complex interventions for CAYP with ADHD require methods like RE and co-design.
- Developed guidelines can inform future technology development for ADHD self-management.
- Partnership with stakeholders enhances the likelihood of intervention success.
Background:
Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. ADHD can affect the individual, the individual's family, and the community. ADHD is managed using pharmacological and nonpharmacological treatments, which principally involves others helping children and young people (CAYP) manage their ADHD rather than learning self-management strategies themselves. Over recent years, technological developments have meant that technology has been harnessed to create interventions to facilitate the self-management of ADHD in CAYP. Despite a clear potential to improve the effectiveness and personalization of interventions, there are currently no guidelines based on existing evidence or theories to underpin the development of technologies that aim to help CAYP self-manage their ADHD.
Objective:
The aim of this study was to create evidence-based guidelines with key stakeholders who will provide recommendations for the future development of technological interventions, which aim to specifically facilitate the self-management of ADHD.
Methods:
A realist evaluation (RE) approach was adopted over 5 phases. Phase 1 involved identifying propositions (or hypotheses) outlining what could work for such an intervention. Phase 2 involved the identification of existing middle-range theories of behavior change to underpin the propositions. Phase 3 involved the identification and development of context mechanism outcome configurations (CMOCs), which essentially state which elements of the intervention could be affected by which contexts and what the outcome of these could be. Phase 4 involved the validation and refinement of the propositions from phase 1 via interviews with key stakeholders (CAYP with ADHD, their parents and specialist clinicians). Phase 5 involved using information gathered during phases 1 to 4 to develop the guidelines.
Results:
A total of 6 specialist clinicians, 8 parents, and 7 CAYP were recruited to this study. Overall, 7 key themes were identified: (1) positive rewarding feedback, (2) downloadable gaming resources, (3) personalizable and adaptable components, (4) psychoeducation component, (5) integration of self-management strategies, (6) goal setting, and (7) context (environmental and personal). The identified mechanisms interacted with the variable contexts in which a complex technological intervention of this nature could be delivered.
Conclusions:
Complex intervention development for complex populations such as CAYP with ADHD should adopt methods such as RE, to account for the context it is delivered in, and co-design, which involves developing the intervention in partnership with key stakeholders to increase the likelihood that the intervention will succeed. The development of the guidelines outlined in this paper could be used for the future development of technologies that aim to facilitate self-management in CAYP with ADHD.
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