Pugatch Marianne, Blum Nathan J, Barbaresi William J, Rowe Jonathan, Berna Mark, Hennigan Sean, Giovanelli Alison, Penilla Carlos, Tebb Kathleen P, Mott Megan, Kumaran Vikram, Buckelew Sara, Lester James C, Ozer Elizabeth
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States.
Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Front Educ (Lausanne). 2023;8. doi: 10.3389/feduc.2023.1183994. Epub 2024 Jan 4.
Attention deficit hyperactivity disorder (ADHD) affects about 13% of adolescents and is associated with substance use-related morbidity and mortality. While evidence on effective interventions to reduce alcohol use among adolescents with ADHD is limited, parent-teen communication about alcohol use has been found to be protective. Other approaches, such as educational interventions, hold promise to reduce alcohol-related harms in adolescents with ADHD. Digital technology offers an innovative approach to health behavior change, expanding access to services and may promote learning for neurodiverse youth, including teens with ADHD. INSPIRE, a narrative-centered game-based behavior change environment designed to promote self-regulation and self-efficacy to prevent risky alcohol use has been found to engage a general adolescent population. The goals of this pilot study are (1) to examine the engagement of youth with ADHD in INSPIRE; and (2) to examine if INSPIRE fosters parent-teen communication.
Adolescents diagnosed with ADHD aged 14-16 were recruited from developmental medicine clinics and invited to a focus group offered via Zoom. Participants completed a pre-survey, interacted with the INSPIRE game, and answered a post-survey as well as open-ended questions about their gaming experience during the focus group. Engagement was measured through both self-report using subscales from the User Engagement Scale and computer data; survey and qualitative data collected information on parent-teen communication. Univariate statistics described adolescent characteristics, Rank-sum and Fisher's exact tests examined relationships among variables, and qualitative analysis identified themes in open-ended questions.
Of adolescent participants ( = 40), 45% identified as female, 17.5% Black, 7.5%, Hispanic, and 62.5% White. Post-survey mean engagement subscales of Usability (on a 5-point scale) was 3.67 (SD = 0.74), and Satisfaction was 3.63 (SD = 0.75). Computer data indicated that participants played the game for a median of 24 min. Adolescents shared that playing the game strengthened refusal skills and their ability to navigate social gatherings with alcohol. Post-survey, 63% planned to share information from INSPIRE with a parent.
Findings suggest that INSPIRE may support facilitating youth with ADHD to learn the developmental competencies needed to mitigate risk and thrive. INSPIRE warrants further testing to explore its impact on alcohol use in youth with ADHD.
注意缺陷多动障碍（ADHD）影响着约13%的青少年，且与物质使用相关的发病率和死亡率有关。虽然关于减少ADHD青少年饮酒的有效干预措施的证据有限，但已发现父母与青少年关于饮酒的沟通具有保护作用。其他方法，如教育干预，有望减少ADHD青少年与酒精相关的危害。数字技术为健康行为改变提供了一种创新方法，扩大了服务获取途径，可能促进包括ADHD青少年在内的神经多样性青少年的学习。INSPIRE是一种以叙事为中心的基于游戏的行为改变环境，旨在促进自我调节和自我效能感以预防危险饮酒，已被发现能吸引一般青少年群体。这项试点研究的目标是：（1）研究ADHD青少年对INSPIRE的参与度；（2）研究INSPIRE是否促进父母与青少年的沟通。
从发育医学诊所招募14至16岁被诊断为ADHD的青少年，并邀请他们参加通过Zoom提供的焦点小组。参与者完成一份预调查，与INSPIRE游戏互动，并在焦点小组期间回答一份后调查以及关于他们游戏体验的开放式问题。通过使用用户参与量表的子量表进行自我报告和计算机数据来衡量参与度；调查和定性数据收集了关于父母与青少年沟通的信息。单变量统计描述了青少年特征，秩和检验和费舍尔精确检验检查了变量之间的关系，定性分析确定了开放式问题中的主题。
在青少年参与者（n = 40）中，45%为女性，17.5%为黑人，7.5%为西班牙裔，62.5%为白人。后调查中，可用性（5分制）的平均参与度子量表得分为3.67（标准差 = 0.74），满意度为3.63（标准差 = 0.75）。计算机数据表明参与者玩游戏的中位数时间为24分钟。青少年表示玩游戏增强了他们的拒绝技能以及在有酒精的社交场合中应对的能力。后调查中，63%的人计划与父母分享INSPIRE中的信息。
研究结果表明，INSPIRE可能有助于促进ADHD青少年学习减轻风险和茁壮成长所需的发展能力。INSPIRE值得进一步测试，以探索其对ADHD青少年饮酒的影响。
