Can digital measurement-based care reduce symptoms of inattention, hyperactivity and opposition in children and adolescents? A retrospective analysis of Bend Health (Preprint)

BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and associated behavioral disorders are highly prevalent in children and adolescents, yet many of them do not receive the care they need. Digital mental health interventions (DMHIs) may address this need by providing accessible and high-quality care. Given the necessity for high levels of caregiver and primary care practitioner involvement in addressing ADHD symptoms and behavioral problems, collaborative care interventions that adopt a whole-family approach may be particularly well-suited to reduce symptoms of inattention, hyperactivity, and opposition in children and adolescents. OBJECTIVE The purpose of this study was to utilize member (i.e., children and adolescent) data from Bend Health Inc., a collaborative care DMHI that uses a whole-family approach to address child and adolescent mental health concerns, to 1) determine the effects of a collaborative care DMHI on inattention, hyperactivity, and oppositional symptoms in children and adolescents, and 2) assess whether collaborative care DMHI effectiveness may be modulated by various factors, including symptom type and demographics. METHODS Caregivers of children and adolescents with elevated symptoms of inattention, hyperactivity, and/or opposition assessed their children’s symptom severity every 30 days while participating in Bend Health Inc. Data from 78 children and adolescents ages 2 to 17 were used to assess symptom severity (inattention symptom group: n = 68; hyperactivity symptom group: n = 33; oppositional symptom group: n = 47). RESULTS Members received care for up to 202 days and attended between 0 and 19 coaching, therapy, and psychiatry sessions through Bend Health Inc. Symptom severity decreased over the course of treatment with Bend Health Inc. for inattention (average decrease: 6.08 points; P < .001), hyperactivity (average decrease: 5.18 points; P = .013), and opposition (average decrease: 4.53 points; P = .002), with the largest changes observed for inattention symptoms and the smallest changes observed for oppositional symptoms. Demographic factors were not associated with symptom severity. CONCLUSIONS This study offers compelling evidence that collaborative care DHMIs can fill the growing need for accessible and high-quality care delivered to children and adolescents with symptoms of ADHD and/or behavioral problems.