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Understanding Barriers and Facilitators of Attention-Deficit/Hyperactivity Disorder Treatment Initiation and
Kelly Kamimura-Nishimura1, Hannah Bush2, Paola Amaya de Lopez1
1Department of Pediatrics (K Kamimura-Nishimura, P Amaya de Lopez, L Crosby, AC Modi, and TE Froehlich), University of Cincinnati College of Medicine, Cincinnati Children...s Hospital Medical Center,.ßOhio.
Insights
Barriers like lack of support and limited resources hinder Attention-Deficit/Hyperactivity Disorder (ADHD) treatment in minoritized children. Caregiver experience and strong support systems facilitate treatment initiation and adherence for better outcomes.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Health Equity
Background:
- Consistent treatment is crucial for managing Attention-Deficit/Hyperactivity Disorder (ADHD).
- Treatment initiation and adherence rates are suboptimal among minoritized children with ADHD.
- Addressing these disparities is essential for improving health outcomes.
Purpose of the Study:
- To explore barriers and facilitators to ADHD treatment initiation and adherence in minoritized children.
- To inform the development of a culturally tailored family navigation intervention.
- To enhance ADHD management strategies for underserved populations.
Main Methods:
- Conducted 7 focus groups and 6 individual interviews virtually.
- Included 4 stakeholder groups: experienced caregivers, newly diagnosed caregivers, family navigators, and clinicians.
- Utilized thematic analysis to identify barriers and facilitators from data collected in English and Spanish sessions.
Main Results:
- Key barriers included lack of school/healthcare/family support, cultural factors, limited resources, access issues, and treatment concerns.
- Facilitators comprised caregiver experience with ADHD, strong support networks, resource availability, and observed functional improvements in children.
- Variability in barrier/facilitator endorsement was noted across participants.
Conclusions:
- Caregiver experience, knowledge, support, and resource access are critical facilitators for ADHD treatment in minoritized children.
- Culturally tailored, multipronged interventions can improve ADHD treatment initiation, adherence, and outcomes.
- Findings support the development of targeted interventions to address disparities in ADHD care.
Objective:
Despite evidence that consistent treatment is important for Attention-Deficit/Hyperactivity Disorder (ADHD) management, ADHD treatment initiation and adherence remains suboptimal in minoritized children. The goal of this study was to explore barriers and facilitators to ADHD treatment initiation/adherence for minoritized children to further inform development of our family navigation intervention.
Methods:
Using a virtual platform, we completed 7 focus group sessions (total n.ß=.ß26) and 6 individual interviews with representatives from 4 stakeholder groups: experienced caregivers of children with ADHD, caregivers of children newly diagnosed with ADHD, family navigators, and clinicians who care for children with ADHD. All caregivers identified as Black and/or Latinx. Separate sessions were conducted for each stakeholder group and caregivers had the option to attend an English or Spanish session. Using a thematic analysis strategy, barriers and facilitators to ADHD treatment initiation and/or adherence were coded in focus group/interview data and themes were identified across groups.
Results:
The primary barriers to ADHD treatment initiation and/or adherence identified for minoritized children were lack of support from school/healthcare/family members, cultural barriers, limited resources, limited access, and treatmentconcerns, with variability in endorsement across participants. Reported facilitators included caretakers having experience with ADHD, strong support, access to resources, andwitnessing their child...s functional improvement with treatment.
Conclusions:
Caregiver experience with and knowledge about ADHD, support, and access to resources facilitate ADHD treatment in minoritized children. The results from this study have the potential to improve ADHD treatment initiation/adherence and outcomes for minoritized children through the development of culturally tailored, multipronged interventions.
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