CONIFAS-2

Summary

ADHD affects 5% of UK children and can have significant impacts on daily functioning and outcomes across multiple health domains. Research and clinical practice indicate families currently have little access to appropriate, timely interventions post-diagnosis. Nature-based interventions represent a promising but under-researched approach to supporting children with ADHD in their symptom management and wellbeing. Systematic reviews highlight the beneficial impact of green space exposure on children’s behavior including a consistent positive association with access to green space and health outcomes for children with ADHD.

This study builds on a successfully completed tier 3 RfPB study called CONIFAS-1 (NIHR203043) that co-produced a nature-based intervention for children with ADHD.

The CONIFAS intervention is a home-based, family-led intervention delivered with professional third-party telephone support. It encourages daily engagement with nature for at least 10 minutes, including activity cards and supportive psychoeducational elements. CONIFAS is ready to be tested in NHS funded neurodiversity services assessing the feasibility and acceptability of a full-scale effectiveness trial.

What we plan to do

Aims and Objectives

The overarching aim is to conduct a feasibility RCT of the CONIFAS intervention in NHS Children’s neurodiversity services.

The specific objectives will address uncertainties regarding:

The feasibility and acceptability of trial processes related to recruitment, randomisation, collecting health/wellbeing outcomes, delivery methods, and health economic outcomes.

The feasibility and acceptability of delivering CONIFAS in neurodiversity services; experiences of children and their families of receiving and staff experiences of delivering the intervention.

How the intervention will be embedded into practice to understand how context affects implementation and outcomes.

Methods

A multi-centre, mixed method randomised, controlled, feasibility trial will be conducted with embedded process evaluation utilising qualitative interviews and visual methods to support data collection (e.g., photo elicitation).

A patient and public involvement (PPI) group will guide the study alongside the co-applicants.  The PPI group will consist of 8-10 parents and their children with ADHD diagnosis. Previous co-production children, parents and guardians will be invited to take part.  This group will meet on 8 occasions throughout the study with face-to-face meetings to take place in a Kids charity venue with a celebration event at Barlow Common Nature reserve.