The Mental Health Training Program’s Evaluation and Quality Improvement (EQI) Lab continues to demonstrate how trainee-led scholarship can drive meaningful improvements in patient care. This year, psychology residents Jacqueline Duong, PhD (San Leandro), and Jenna Kim, PhD (Santa Clara), led an implementation science project examining treatment engagement among children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) across Kaiser Permanente Northern California.
Under the mentorship of Ana Zdravkovic, PhD, ABPP, Research Training Director for the Mental Health Training Program, and in collaboration with data analyst Galina Kovaleva, PhD, the trainee team conducted a large-scale needs assessment involving 4,658 children ages 6-12 who received an ADHD diagnosis in 2023. Guided by the Knowledge-to-Action Framework, the project sought to understand how provider discipline and clinical setting influence whether children engage in recommended ADHD treatments following diagnosis.
ADHD affects nearly one in nine children in the United States, and evidence-based guidelines recommend multimodal care, including behavioral interventions, medication management, and educational support. Yet nationally, many children fail to engage in treatment after diagnosis. The trainee team set out to better understand how existing systems of care can promote early and sustained treatment engagement.
The findings highlighted a significant organizational strength: children diagnosed by mental health providers were highly likely to initiate psychotherapy, while those diagnosed by medical providers were highly likely to begin medication treatment. Similarly, departments with embedded therapy services demonstrated especially strong rates of psychotherapy engagement. Overall, treatment initiation rates across Kaiser Permanente Northern California exceeded many rates reported in community-based samples, underscoring the value of integrated medical and behavioral health services.
Importantly, the project moved beyond identifying outcomes to exploring opportunities for continuous improvement. The team proposed future initiatives focused on strengthening cross-disciplinary referrals, increasing access to treatment information, and enhancing collaborative treatment planning between medical and mental health providers. These efforts may help families more readily access the full spectrum of evidence-based ADHD care.
This project exemplifies the mission of the Evaluation and Quality Improvement Lab: engaging psychology trainees in implementation science while generating actionable insights that improve healthcare delivery. Through hands-on experience with member-level data, quality improvement methods, and dissemination activities, trainees develop advanced competencies as both clinicians and healthcare innovators.
The work has already been disseminated through a work-in-progress poster presentation at SCOPE, and a manuscript is currently being prepared for submission. As the project advances into its next phase, it will continue to showcase the powerful impact of trainee-led research on patient care, health system improvement, and the future of integrated behavioral health services.
