Enhancing Social Skills of Young Children With ADHD: Effects of a Sibling-Mediated Intervention

Children with attention deficit/hyperactivity disorder (ADHD) are at risk for experiencing problems with social functioning that are associated with adverse outcomes in adolescence and adulthood. To date, the most common ADHD treatments for children, psychostimulants and adult-mediated interventions, have had limited success reducing social impairments associated with ADHD. Using a non-concurrent multiple baseline across participants design, we examined the efficacy of a sibling-mediated social intervention for reducing negative and increasing positive social behaviors of three children with ADHD. We also assessed implementation integrity by the siblings, and acceptability from the perspective of the participant with ADHD, the siblings, and the parents. Results indicated that siblings learned and used specific social skills strategies with their siblings with ADHD that lead to increases in sharing, helping, and compromising behaviors for children with ADHD compared with baseline (Tau- U = 0.9531, p < .001). Summary of findings, study limitations, implications for research, and practice are discussed.

Studying Implementation within a Continuous-Improvement Process: What Happens When We Design with Adaptations in Mind?

Background/Context This study examines the implementation of an academic and social-emotional learning innovation called Personalization for Academic and Social Emotional Learning, or PASL. The innovation was designed, tested, and implemented using a continuous continuous-improvement model. The model emphasized a top-and-bottom process in which implementers played a central role in the innovation design, and adaptations were planned, tested, and refined based on local school contexts. Purpose This study sought to understand what implementation integrity looked like in three high schools participating in a continuous continuous-improvement process that promoted deliberate, planned adaptations to PASL, and as well as to uncover factors that may explain differences in the integrity of PASL implementation across the three schools. Research Design We conducted embedded, qualitative case studies of three large, racially-, ethnically-, and linguistically- diverse urban high schools. Data collected and analyzed included interviews with school innovation design design-team members, student focus groups, and observations of teachers implementing PASL. Findings Each school made site-specific adaptations to the PASL innovation before and during implementation. However, there was variation in the extent to which the schools demonstrated integrity to the PASL design and their own adaptations. A combination of local contextual factors helped explain differences in implementation integrity across the schools. These factors included the availability of resources and ongoing technical support, the will of local implementers, and perceptions about policy alignment. Conclusions/Recommendations While PASL was implemented across the three school sites, the degree of implementation integrity varied, suggesting that encouraging program adaptation alone may not solve longstanding challenges associated with achieving depth of implementation. This is the first study of its kind in education, however, and more research is clearly warranted.

Process evaluation of a randomised controlled trial of a diabetes prevention intervention in Dutch primary health care: the SLIMMER study

ObjectiveTo investigate (i) how the SLIMMER intervention was delivered and received in Dutch primary health care and (ii) how this could explain intervention effectiveness.DesignA randomised controlled trial was conducted and subjects were randomly allocated to the intervention (10-month combined dietary and physical activity intervention) or the control group. A process evaluation including quantitative and qualitative methods was conducted. Data on process indicators (recruitment, reach, dose received, acceptability, implementation integrity and applicability) were collected via semi-structured interviews with health-care professionals (n 45) and intervention participant questionnaires (n 155).SettingSLIMMER was implemented in Dutch primary health care in twenty-five general practices, eleven dietitians, nine physiotherapist practices and fifteen sports clubs.SubjectsSubjects at increased risk of developing type 2 diabetes were included.ResultsIt was possible to recruit the intended high-risk population (response rate 54 %) and the SLIMMER intervention was very well received by both participants and health-care professionals (mean acceptability rating of 82 and 80, respectively). The intervention programme was to a large extent implemented as planned and was applicable in Dutch primary health care. Higher dose received and participant acceptability were related to improved health outcomes and dietary behaviour, but not to physical activity behaviour.ConclusionsThe present study showed that it is feasible to implement a diabetes prevention intervention in Dutch primary health care. Higher dose received and participant acceptability were associated with improved health outcomes and dietary behaviour. Using an extensive process evaluation plan to gain insight into how an intervention is delivered and received is a valuable way of identifying intervention components that contribute to implementation integrity and effective prevention of type 2 diabetes in primary health care.