# Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income Children

> **NIH NIH K23** · BOSTON MEDICAL CENTER · 2020 · $163,137

## Abstract

PROJECT SUMMARY. Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common chronic
conditions in childhood, with significantly higher rates and worse outcomes among socioeconomically
disadvantaged children. Social adversities including unmet basic needs such as food insecurity, housing
instability, and lack of quality child care emerge as potent risk factors for ADHD symptoms as early as the
preschool years. The development of early intervention strategies for young children with both ADHD and
socioeconomic disadvantage is critical for mitigating future impairment. New research demonstrates that a low
intensity, family-centered screening and referral program (WE CARE) at well infant visits is feasible and can
increase receipt of resources for unmet social needs (e.g. food, transportation, and parent education).
Adapting this strategy to target preschoolers with emerging ADHD, who are typically first identified in primary
care, could significantly impact clinical symptoms and disease trajectory during a critical developmental period.
Therefore, the objective of this project is develop an early intervention strategy, adapted from the WE CARE
program, targeting unmet social needs for low-income families of preschool-age children with emerging ADHD.
The WE CARE intervention will be adapted on 3 key domains (for a new target population, content, and
primary outcomes) through the pursuit of 3 interrelated studies. These are: 1) Examine the association
between specific unmet social needs and ADHD symptoms in 7,565 nationally representative children age 3-5
from the National Survey for Children's Health (NSCH) and explore potential mediators of this association
(including parental stress, activation, and unmet need for care) via structural equation modeling (SEM); 2)
Identify parent-reported mechanisms by which unmet social needs exacerbate ADHD symptoms in preschool
age children and how an intervention addressing these needs could improve clinical outcomes by conducting
semi-structured interviews with 25 parents of preschoolers with ADHD symptoms; and 3) Conduct an adaptive,
randomized pilot trial of a novel treatment model addressing unmet social needs with parents of 60 low-income
children age 3-5 with ADHD symptoms. This research plan reflects Objective 3.2 of the NIMH Strategic Plan, to
develop ways to tailor existing and new interventions to optimize outcomes, and addresses an urgent need to
reduce socioeconomic disparities in pediatric mental health outcomes by targeting modifiable risk factors in
vulnerable young children. These research aims will also serve as vehicles for pragmatic learning of the
following training goals: 1) Learn advanced statistical modeling and measurement methods for social
determinants research; 2) Gain expertise in intervention development to reduce mental health disparities; and
3) Obtain training in modern clinical trial design for the study of psychosocial and health services interventions.
This mentor...

## Key facts

- **NIH application ID:** 10005474
- **Project number:** 5K23MH118478-03
- **Recipient organization:** BOSTON MEDICAL CENTER
- **Principal Investigator:** Andrea Spencer
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $163,137
- **Award type:** 5
- **Project period:** 2018-09-21 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10005474

## Citation

> US National Institutes of Health, RePORTER application 10005474, Developing a Pediatrics-based Social Needs Intervention to Reduce Disparities in ADHD Outcomes for Low-income Children (5K23MH118478-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10005474. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*