Reducing Disparities in Behavioral Health Treatment for Children in Primary Care

The purpose of this study is to address a decisional dilemma faced by health system officials, policy makers, and clinical leaders: "Does it make sense to integrate behavior therapy into primary care practice to treat children with ADHD from low-income settings? More specifically, does integrated care improve access to services and patient-centered outcomes for underserved children with ADHD?" Participants will be randomly assigned to one of two groups: Behavior therapy integrated into primary care (Partnering to Achieve School Success; PASS program) to treatment as usual (TAU) informed by American Academy of Pediatrics (AAP) guidelines for ADHD practice and facilitated by electronic practice supports." Participants will be 300 children (ages 5-11) with ADHD and their caregivers served at Children's Hospital of Philadelphia Care Network Locations (primary care offices). Participants are drawn from primary care locations that serve primarily low-income and racial/ethnic minority population.

Inclusion Criteria: * Children between the ages of 5 and 11 years (as reported in EHR at the time of referral to the study team) * Children receiving care in one of the seven targeted CHOP practices for this study * Children with an existing diagnosis of ADHD (as indicated by the referring primary care provider or behavioral health provider and/or EHR) * Children with one or more areas of impairment (score of 3 or 4 on scale ranging from 1 to 4) * Evidence that child may be in a family of low-income status, as indicated by child eligibility for Medicaid or Children's Health Insurance Program (CHIP) OR child living in a census tract or census block with median income at or below two times the federal poverty level * Parental/guardian permission (informed consent) and if appropriate, child assent. Exclusion Criteria: * Child has autism spectrum disorder * Child has an intellectual disability * Child has a comorbid condition that is a major clinical concern and requires an alternative form of treatment * Child is receiving behavioral health services from another provider at the time of recruitment * Child has a sibling currently enrolled in the study * Child has received Healthy Minds, Healthy Kids (CHOP's Integrated Behavioral Health Service) in the past 6 months