Study
Evans and colleagues (2016) used a stratified random assignment research design to evaluate the Challenging Horizons Program (CHP) in nine urban, suburban, and rural middle schools. Students in sixth to eighth grades were recruited in three cohorts over 3 academic years. Recruitment was conducted in the spring of the academic year prior to the start of the intervention by sending letters home to all parents at participating schools, having school staff directly inform parents of some students about the opportunity to participate, and posting flyers in participating schools. Interested parents/caregivers underwent an initial telephone screening followed by an evaluation to determine students’ eligibility for the study. To be eligible, students had to 1) attend a participating school; 2) meet Diagnostic and Statistical Manual of Mental Disorders [4th ed. text revision (DSM-IV-TR)] diagnostic criteria for attention deficit hyperactivity disorder (ADHD); 3) demonstrate impairment in academic, social, or other relevant domains based on either parent or teacher report; 4) have an IQ score of 80 or greater; and 5) not meet diagnostic criteria for pervasive developmental disorder or serious psychiatric disorder such as schizophrenia or bipolar disorder.
After screening for eligibility and completing baseline assessment, students were randomized to one of three study conditions: CHP-Mentoring, CHP-After School, or a Community Care control condition. This review focuses on the comparison of the CHP-Mentoring condition to the control condition. In the CHP-Mentoring condition, each student received a small portion of the CHP-After School intervention from a mentor who was a teacher or other staff member in his or her school. Mentors agreed to meet with their students weekly, with most mentors meeting their students in the morning before classes, during homeroom, at lunch, or during study halls. Participants in the control condition received a list of locally available child and family psychosocial and pharmacological intervention options at the start of the school year.
Participants were 110 sixth- to eighth-grade students in the CHP-Mentoring program and 104 students in the control condition. Mentors and students met an average of 25.17 times and had an average of 1.84 feedback sessions. The average mentor–mentee session lasted 12.12 minutes. Of the mentor–student pairings, 30 percent involved one intervention, 50 percent involved two interventions, 18 percent involved three interventions, and 2 percent involved four interventions. Seventy-five percent of mentor–mentee interventions focused on organizational skills, 53 percent focused on homework-recording accuracy, 30 percent focused on daily report cards, 20 percent focused on missed assignment checks, 10 percent focused on study skills, and 3 percent focused on another type of intervention. The average number of consultant–mentor meetings was 13.39, and the average meeting duration was 19.59 minutes.
Outcome measures were collected from parents at baseline, at four equally spaced times during the intervention year, and then 6 months after the end of the intervention (i.e., halfway through the following school year). These measures included 1) scores from the Task Planning subscale of the Children’s Organizational Skills Scale (COSS), a 58-item scale assessing youth organization, time management, and planning difficulties; and 2) scores from the Inattention and Avoidance of Homework and the Poor Productivity and Nonadherence with Homework Rules subscales of the Homework Problems Checklist, a 20-item rating scale assessing homework performance. Outcome measures were also collected from teachers at all time points except at baseline. These measures included 1) the Academic Competence subscale of the Classroom Performance Survey (CPS), a 15-item rating scale assessing academic and interpersonal competence; 2) reports of the percentage of assignments turned in; 3) the Academic Progress subscale of the Impairment Rating Scale (IRS), a 7-item rating scale assessing areas of impairment at school; and 4) the Inattention, Hyperactivity/Impulsivity, and Oppositional Defiant Disorder (ODD) subscales of the Disruptive Behavior Disorders Rating Scale (DBD), a 26-item checklist for symptoms of ADHD and ODD. Grades for each participating student were also collected at baseline (i.e., the last quarter of the previous school year), at four points during the intervention year (i.e., for each quarter of school), and at four points during the year following the intervention (i.e., for each quarter of the follow-up year) and converted into GPAs for core subject areas (English/language arts, social studies, math, and science). Parents were also asked about their child’s use of medication and other treatment for ADHD at each assessment point.
Intervention effects on youth functioning were assessed using hierarchical linear modeling (HLM) via a linear mixed effect model. All analyses used an intent-to-treat (ITT) approach (i.e., including data from all participants randomized into a condition regardless of level of participation in intervention activities). The basic models included group assignment, time, and group-by-time interaction as predictors of outcomes, with control for baseline achievement scores, intelligence estimate, family income, and parental education. Medication use was included as a time-varying covariate.
