title: Feasibility of conducting a randomized controlled trial of telemental health with children diagnosed with attention-deficit/hyperactivity disorder in underserved communities.
abstract: OBJECTIVE
  Telemental health (TMH), the use of videoteleconferencing to provide care that is usually delivered in person, is increasingly used to rectify disparities in access to care. Few studies, however, have been conducted to demonstrate the effectiveness of TMH as a service delivery model. The Children's Attention-Deficit/Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) is a randomized clinical trial (RCT) of TMH conducted in multiple underserved communities. This article reports on the feasibility of conducting an effectiveness trial of TMH with children.
  
  
  METHODS
  The CATTS trial used videoteleconferencing to provide guideline-based care and secure web sites to coordinate key aspects of trial implementation, such as participant recruitment and retention, intervention fidelity, and completion of assessments.
  
  
  RESULTS
  The CATTS trial engaged seven communities and 150 primary care providers as partners in the study, and enrolled 223 children 5.5-12.9 years old. The intervention group completed an average of 5.3 of 6.0 planned sessions and 96% of controls completed a TMH consultation. Both groups completed an average of 4.8 of the 5.0 assessments. Clinicians demonstrated high fidelity to their treatment protocols. Minor technical difficulties did not interfere with providing care.
  
  
  CONCLUSIONS
  The CATTS trial demonstrated the feasibility of conducting an RCT of TMH with children living in multiple underserved communities. Telecommunications technologies can facilitate the coordination of research activities across sites and clinicians. Future trials should work closely with study partners to ensure referral of a representative study sample. Further trials are needed to help establish the effectiveness of TMH as a service delivery model.
  
  
  BACKGROUND
  http://clinicaltrials.gov/show/NCT00830700 .
authors: Department of Psychiatry and Behavioral Medicine, Seattle Children's Hospital, Seattle, Washington 98105, USA. kathleenmyers786@comcast.net
authors: Kathleen
authors: K
authors: Myers
authors: Ann
authors: A
authors: Vander Stoep
authors: Caitlin
authors: C
authors: Lobdell
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008605:Mental Health Services / Q000600:supply & distribution*; D017410:Practice Guidelines as Topic; D013685:Telecommunications; D017216:Telemedicine / Q000379:methods*; D016896:Treatment Outcome
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