Supporting Decision Making on ADHD Medication: Development and Evaluation of a Decision Aid for Parents

Background. Parents of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) often encounter complex treatment decisions, especially the initiation of pharmacologic therapy. While evidence-based decision aids facilitate informed, values-congruent choices, tools remain limited outside English-speaking settings. Objective. This study aimed to develop and evaluate the feasibility and acceptability of a Hebrew-language decision aid intended to support parents in making informed decisions regarding the initiation of ADHD medication for their children. Methods. The development process adhered to the International Patient Decision Aid Standards and was guided by the Ottawa Decision Support Framework. Acceptability testing involved 20 stakeholders using a mixed-methods questionnaire. Field testing used a pre/post design with 38 parents of children recently diagnosed with ADHD. Outcomes, measured using validated instruments, were knowledge, decisional conflict, decision self-efficacy, decision preparedness, and preference about SDM. Results. Most participants found the decision aid to be clear, well-structured, and easy to understand. All (100%) agreed it would be helpful for others facing similar decisions. Compared with baseline, post-decision aid parental knowledge significantly increased (67.4 to 84.7 out of 100; P < 0.001) and decisional conflict decreased (29.8 to 20.8 out of 100; P = 0.01). Decision self-efficacy increased from 83.6 to 90.0 out of 100 (P = 0.09). Participants reported high decision preparedness (mean = 89.5 of 100), and 45% preferred shared decision making with the physician. Conclusions. The systematically developed decision aid about ADHD treatments demonstrated feasibility and acceptability. It showed potential to enhance informed, value-based parental decision making; reduce decisional conflict; and facilitate shared decision making in pediatric clinical care.

A decision aid was developed to support parents in making ADHD medication decisions.The decision aid significantly increased parents' knowledge about ADHD and treatment options and reduced parents' decisional conflict.Stakeholders, including parents and health care professionals, reported that the decision aid was acceptable.The decision aid prepared parents for shared decision making within pediatric ADHD care.