Implementing a Canadian shared-care ADHD program in Beijing: Barriers and facilitators to consider prior to start-up

Area of Science:

• Mental Health Services Research
• Healthcare System Implementation
• Cross-Cultural Adaptation of Medical Models

Background:

• Shared care pathways, originating in Canada, aim to improve ADHD management by integrating general practitioners (GPs) and specialists.
• This model involves adjusting care levels based on patient complexity and outcomes.

Purpose of the Study:

• To identify challenges and facilitators for implementing a Canadian shared care pathway for Attention Deficit Hyperactivity Disorder (ADHD) within a Chinese mental health service setting.

Main Methods:

• Two focus groups with 7 healthcare providers in Beijing utilized semi-structured interviews.
• An adapted grounded theory methodology with open-ended, axial, and selective coding informed data analysis.

Main Results:

• Barriers and facilitators were identified across sociocultural, structural (organizational), and intervention-specific levels.
• Key obstacles include disparities in physician qualifications across hospital tiers and a lack of effective inter-hospital referral systems.

Conclusions:

• Pre-implementation consultation is crucial for understanding the local landscape before adopting established care models.
• Adapting training programs and optimizing referral pathways are essential for successful shared care implementation in China.