Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Attention-deficit/hyperactivity disorder, or ADHD, is a disorder that affects how people learn and relate to others. Students with ADHD may have a hard time paying attention and following classroom rules. ADHD often is treated with medicine by primary care clinicians. Behavior therapy can also help treat ADHD, but families with low incomes may have a hard time obtaining this therapy.

In this study, the research team is comparing two ways to improve access to behavior therapy for children with ADHD in families with low incomes. The first way is a program called Partnering to Achieve School Success, or PASS, which combines behavior therapy with primary care. The second way is usual ADHD primary care plus family education and a referral to community mental health services.

Who can this research help?

Results may help pediatric primary care practices when considering ways to treat children with ADHD in families with low incomes.

What is the research team doing?

The research team is working with primary care clinics to recruit 300 children with ADHD and their caregivers. Children and their caregivers come from families with low incomes. The team is assigning children by chance to one of two groups.

Children in the first group receive the PASS program. PASS uses a team-based approach that combines primary care and behavior therapy services. In this program, caregivers and children receive training from a PASS clinician at a primary care clinic. The program consists of 9 to 12 training sessions over the course of 16 weeks.

PASS clinicians are psychologists and clinical social workers who teach caregivers how to

  • Improve their children’s behavior
  • Empower themselves to seek help
  • Work with teachers to improve behavior at school

Between sessions, a community health worker stays in touch with families to help them keep appointments and use the strategies they learn from PASS.

Children in the second group receive usual ADHD care plus family education. ADHD care may include education on ADHD and ADHD treatments, referral to mental health services, and medicine management. Caregivers in this group have access to two group education sessions about ADHD.

The research team is surveying children, caregivers, and teachers at the start of the study and again four and eight months later. The team is asking about children’s ADHD symptoms, academic progress, behavior, social relationships, and life satisfaction. The team is also looking at medical records to see how often children use healthcare services.

Parents, clinicians, and educators help make decisions about all aspects of the study.

Research methods at a glance

Design Element Description
Design Randomized controlled trial
Population 300 children ages 5–11 who are in kindergarten through grade 5 and who have an ADHD diagnosis and come from families with low incomes 
  • PASS Program
  • Usual ADHD care plus family education

Primary: homework performance, academic progress, academic grades, behavior compliance, ADHD symptoms and emotional and behavioral problems, peer relationships, life satisfaction, service use

Secondary: parent-child relationship, family empowerment, perceptions of team-based care, parent-teacher involvement, satisfaction with treatment

Timeframe 8-month follow-up for primary outcomes 

Engagement Resources

Project Information

Thomas Power, PhD
Children's Hospital of Philadelphia
Reducing Disparities in Behavioral Health Treatment for Children in Primary Care

Key Dates

November 2018
April 2024

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 12, 2024