- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04186312
A Psychosocial Treatment Program for College Students (ACCESS) (ACCESS)
Improving the Educational and Social-Emotional Functioning of College Students With ADHD
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This proposal, "Improving the Educational and Social-Emotional Functioning of College Students with ADHD," was submitted in response to CFDA-84.305A Postsecondary and Adult Education Research, Goal 3 - Efficacy and Replication.
The number of young adults with Attention-Deficit/Hyperactivity Disorder (ADHD) pursuing college degrees has increased dramatically over the past 30 years. Students with ADHD currently represent one of the largest disability groups on college campuses, with at least 25% of all college students who receive disability services identified with ADHD. The need for such services is clearly warranted, given that college students with ADHD are at increased risk for having low and failing grades, being placed on academic probation, and ultimately dropping out of college. Currently, many colleges and universities offer students with ADHD extended time and other accommodations. Unfortunately, use of these accommodations is not empirically supported, presumably because they do not address the core difficulties - deficits in executive and psychological functioning - shown to lead to educational impairment in college students with ADHD. Further complicating matters is that systematic investigation of potentially useful psychosocial interventions for college students with ADHD has been lacking.
The investigators set out to address this gap by working with stakeholders to develop a psychosocial intervention for college students with ADHD, known as ACCESS - Accessing Campus Connections and Empowering Student Success. Development of ACCESS was guided by careful consideration of conceptual and empirical factors thought to contribute to the difficulties experienced by college students with ADHD, thus resulting in an intervention that specifically targets executive functioning, other core ADHD features, and psychological functioning. To date, a detailed treatment manual has been developed and revised through an iterative process. A large open trial of ACCESS was recently completed by one of the PIs and a second open trial of a similar intervention was independently completed by the other PI. These trials demonstrate the feasibility of delivering ACCESS on college campuses with fidelity and establish preliminary efficacy. In both trials, college students with ADHD made significant improvements in ADHD symptom severity, executive functioning, educational performance, and emotional functioning. Although promising, such findings are limited by the absence of control groups, thereby preventing firm conclusions about efficacy. Accordingly, the primary goal of this Goal 3 study is to conduct a multi-site randomized controlled trial to evaluate the efficacy of the ACCESS intervention and to assess moderators and mediators of intervention response.
College students with ADHD (N=240) from two large, diverse public universities were randomly assigned either to ACCESS or to a delayed treatment condition. Five cohorts of students were recruited, with each cohort consisting of 24 students from each site. Educational, executive, psychological, and social functioning, as well as service utilization, were assessed at pre-treatment, at the end of active intervention, at the end of the maintenance phase, and during a 6-month follow-up. An intent-to-treat analysis was used to assess the efficacy of ACCESS. Moderator and mediator analyses will also be conducted to address the types of students most likely to benefit from ACCESS and to evaluate key mechanisms of change that lead to improved academic and social-emotional functioning.
This study has significant potential to improve the performance of college students with ADHD because the intervention was specifically designed to address deficits in executive and psychological functioning, factors shown to predict the educational outcomes of college students with ADHD. Further, the ACCESS intervention was designed with stakeholder input and thus has clear potential for dissemination upon proof of efficacy.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- voluntary consent
- 18-30 years of age
- DSM-5 criteria for ADHD
- estimated IQ greater than 85
Exclusion Criteria:
- co-occurring autism spectrum disorder, bipolar disorder, obsessive-compulsive disorder, and/or active substance abuse
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Immediate Treatment
Cognitive-Behavioral Treatment program known as ACCESS
|
Cognitive-Behavioral Treatment delivered across 2 semesters via group and individual mentoring sessions
|
Other: Delayed Treatment
Allowed to receive treatment as usual during study, then received ACCESS after delay of two-semesters
|
Cognitive-Behavioral Treatment delivered across 2 semesters via group and individual mentoring sessions
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Conners' Adult ADHD Rating Scale: DSM-IV Inattention Symptom subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess changes in inattention symptoms, scores range from 0-27, higher scores reflect worse functioning.
|
4 months, 8 months, 14 months
|
Conners' Adult ADHD Rating Scale: DSM-IV Hyperactive-Impulsive Symptom subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess changes in hyperactive-impulsive symptoms, scores range from 0-27, higher scores reflect worse functioning.
|
4 months, 8 months, 14 months
|
Behavior Rating Inventory of Executive Function, Adult Version - Global Executive Composite subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess changes in self-reported overall executive functioning, scores range from 70-210, higher scores indicate worse functioning
|
4 months, 8 months, 14 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ADHD Impact Module - Adult: Performance and Daily Functioning subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess changes in performance and daily functioning, scores range from 0-100, higher scores reflect better functioning.
|
4 months, 8 months, 14 months
|
ADHD Impact Module - Adult: General Well-Being subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess changes in general well-being, scores range from 0-100, higher scores reflect better functioning.
|
4 months, 8 months, 14 months
|
Learning & Study Strategies Inventory: Test Strategies subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess self-reported changes in academic functioning, scores range from 8-40, higher scores reflect better functioning.
|
4 months, 8 months, 14 months
|
Learning & Study Strategies Inventory: Study Aids subscale
Time Frame: 4 months, 8 months, 14 months
|
Used to assess self-reported changes in academic functioning, scores range from 8-40, higher scores reflect better functioning.
|
4 months, 8 months, 14 months
|
Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Arthur D Anastopoulos, Ph.D., UNC Greensboro
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 15-0216
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- ANALYTIC_CODE
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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