# Improving Medication Continuity among Adolescents with ADHD

> **NIH NIH R34** · CINCINNATI CHILDRENS HOSP MED CTR · 2020 · $159,000

## Abstract

PROJECT SUMMARY/ABSTRACT
 Medication is an efficacious treatment strategy for adolescents with attention-deficit/hyperactivity
disorder (ADHD) (Chan et al. 2016), however use significantly declines during adolescence when the
consequences of ADHD are most severe (e.g. dropping out of school, delinquency, etc.). The Unified Theory
of Behavior Change (UTBC) (Fishbein et al. 2001) has been proposed as a conceptual model to explain the
mechanism underlying ADHD medication adherence and to guide the development of interventions to improve
the continuity of treatment (Chacko et al. 2010). The UTBC is a well-established and empirically tested model
that identifies factors that influence an individual’s intention to perform a behavior as well as factors that
influence whether a behavior is actually carried out. Indeed, our preliminary data support the relevance of pre-
intention factors and implementation factors for medication continuity among adolescents with ADHD.
Currently, no evidence-based interventions target medication continuity for adolescents with ADHD. Our
research team is well positioned to create an intervention that addresses each of the main UTBC factors
influencing the intention and implementation of regular medicine taking. Such an intervention would transform
care for adolescents with ADHD and help prevent the alarming fall-off in effect size from medication efficacy
studies to effectiveness in real world practice caused by poor adherence. The overall objective of this
application is to develop and test a multi-component intervention that systematically identifies and targets
aspects of the UTBC model most relevant for each adolescent with poor ADHD medication continuity. Our
central hypothesis is that our tailored intervention will support ADHD medication continuity. We will objectively
test our central hypothesis by accomplishing the following specific aims: 1) Design, build, and optimize the
usability of web-based intervention components to support medication continuity among adolescents with
ADHD using an iterative stakeholder-centered design approach involving all stakeholders (i.e., adolescents,
parents, and pediatricians) in all stages of development, and 2) Conduct a 12-month stepped wedge cluster
randomized controlled trial among adolescents with poor medication continuity to test whether the intervention
engages the mechanism underlying medication continuity and improves outcomes. Preliminary data
generated from this project will be used to support a future R01 application to test the intervention in a larger
stepped wedge cluster RCT that is powered to detect differences accounting for clustering within practices and
to formally assess moderators and mediators of outcomes.

## Key facts

- **NIH application ID:** 9850639
- **Project number:** 5R34MH112648-03
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** William Bernard Brinkman
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $159,000
- **Award type:** 5
- **Project period:** 2018-04-12 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850639

## Citation

> US National Institutes of Health, RePORTER application 9850639, Improving Medication Continuity among Adolescents with ADHD (5R34MH112648-03). Retrieved via AI Analytics 2026-07-01 from https://api.ai-analytics.org/grant/nih/9850639. Licensed CC0.

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