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Olatunji G, Faturoti O, Jaiyeoba B, Toluwabori AV, Adefusi T, Olaniyi P, Aderinto N, Abdulbasit MO. Navigating unique challenges and advancing equitable care for children with ADHD in Africa: a review. Ann Med Surg (Lond) 2023; 85:4939-4946. [PMID: 37811061 PMCID: PMC10553014 DOI: 10.1097/ms9.0000000000001179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 10/10/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents distinct challenges for African children due to a complex interplay of social, economic and cultural factors. This review examines the various obstacles faced by children with ADHD in Africa, focusing on the lack of awareness and stigma surrounding the disorder, limited access to mental health services, educational system constraints, economic limitations and cultural beliefs and practices. The review underscores the significance of public awareness campaigns and educational initiatives to dispel myths and misconceptions surrounding ADHD. These efforts should target the general public, educators, healthcare professionals, religious leaders and traditional healers. Crucial to addressing this issue is strengthening mental health services, especially in rural and underserved areas, through increased funding and the availability of trained mental health professionals specialised in ADHD diagnosis and treatment. Integrating mental health services into primary healthcare systems is proposed to enhance accessibility for children with ADHD. By training primary care providers to recognise ADHD symptoms and provide initial support and referrals, early identification and intervention can be facilitated. Addressing the affordability and accessibility of ADHD treatment is a priority, with policy recommendations including subsidising medications and therapies and providing financial assistance to families in need. A call for collaborative efforts between governments, nongovernmental organisations and pharmaceutical companies is advocated to ensure that ADHD treatment is affordable and widely available.
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Affiliation(s)
| | - Olamide Faturoti
- Department of Medicine and Surgery, University of Ilorin, Ilorin
| | | | | | | | - Peter Olaniyi
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Muili O. Abdulbasit
- Department of Medicine and Surgery, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
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Sevastidis A, Wanni Arachchige Dona S, Gold L, Sciberra E, Coghill D, Le HND. Social gradient in use of health services and health-related quality of life of children with attention-deficit/hyperactivity disorder: A systematic review. JCPP ADVANCES 2023; 3:e12170. [PMID: 37720590 PMCID: PMC10501702 DOI: 10.1002/jcv2.12170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/04/2023] [Indexed: 09/19/2023] Open
Abstract
Aims ADHD (attention-deficit/hyperactivity disorder) affects 5% of children on average. Despite the high need to access services for ADHD treatment, not all children with ADHD utilise healthcare services equally. This study aims to systematically synthesise evidence of equity and equality in health service use/costs and health-related quality of life (HRQoL)/wellbeing of children with ADHD across socioeconomic (SES) classes. Methods The literature search was conducted across seven databases (Academic Search complete, MEDLINE Complete, PsycINFO, ERIC, Global Health, CINAHL and EconLit). The search was limited to peer-reviewed articles published to 23rd January 2023 in English and focused on children. Study quality was assessed using the Critical Appraisal Skills Program (CASP), Joanna Briggs Institute (JBI) and Mixed Methods Appraisal Tool (MMAT) checklists. Results 25 out of 1207 articles were eligible for inclusion. The results showed that SES was associated with different types of healthcare utilisation. Only three studies were found on HRQoL/well-being. Children with ADHD from low SES families had lower HRQoL than children from high SES families. Conclusion This study found that a social gradient exists in both healthcare service use and children's HRQoL among those with ADHD.
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Affiliation(s)
- Abraham Sevastidis
- Deakin Health EconomicsSchool of Health and Social DevelopmentFaculty of HealthDeakin UniversityBurwoodVictoriaAustralia
| | - Sithara Wanni Arachchige Dona
- Deakin Health EconomicsSchool of Health and Social DevelopmentFaculty of HealthDeakin UniversityBurwoodVictoriaAustralia
| | - Lisa Gold
- Deakin Health EconomicsSchool of Health and Social DevelopmentFaculty of HealthDeakin UniversityBurwoodVictoriaAustralia
- Murdoch Children's Research InstituteRoyal Children's HospitalBurwoodVictoriaAustralia
| | - Emma Sciberra
- Murdoch Children's Research InstituteRoyal Children's HospitalBurwoodVictoriaAustralia
- School of PsychologyFaculty of HealthDeakin UniversityBurwoodVictoriaAustralia
- Departments of Paediatrics and PsychiatryFaculty of Medicine, Dentistry and Health SciencesThe University of MelbourneBurwoodVictoriaAustralia
- The Centre for Social and Early Emotional Development (SEED)Deakin UniversityBurwoodVictoriaAustralia
| | - David Coghill
- Murdoch Children's Research InstituteRoyal Children's HospitalBurwoodVictoriaAustralia
- Departments of Paediatrics and PsychiatryFaculty of Medicine, Dentistry and Health SciencesThe University of MelbourneBurwoodVictoriaAustralia
| | - Ha Nguyet Dao Le
- Deakin Health EconomicsSchool of Health and Social DevelopmentFaculty of HealthDeakin UniversityBurwoodVictoriaAustralia
- Murdoch Children's Research InstituteRoyal Children's HospitalBurwoodVictoriaAustralia
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Huang H, Jin Z, He C, Guo S, Zhang Y, Quan M. Chronic Exercise for Core Symptoms and Executive Functions in ADHD: A Meta-analysis. Pediatrics 2023; 151:190271. [PMID: 36510746 DOI: 10.1542/peds.2022-057745] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The effects of chronic exercise interventions (CEIs) on core symptoms and executive functions (EFs) of attention-deficit/hyperactivity disorder (ADHD) and how different characteristics of CEIs could modify the effect remain unclear. We synthesized the current evidence on the effects of CEIs on core symptoms and EFs in children and adolescents with ADHD. METHODS Data sources include PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure from database inception to July 31, 2022. Study selection includes randomized controlled trials that reported on the effects of CEIs on core symptoms and/or EFs in ADHD aged 6 to 18 years. RESULTS Twenty-two randomized controlled trials were included. CEIs had a small beneficial effect on overall core symptoms (standardized mean difference [SMD] = -0.39, 95% confidence interval [CI]: -0.64 to -0.14), as well as inattention (SMD = -0.32, 95% CI: -0.63 to -0.004) among children and adolescents with ADHD. Closed-skill exercise showed a large improvement in core symptoms (SMD = -0.83, 95% CI: -1.30 to -0.35), whereas open-skill exercise did not. Additionally, CEIs had a moderately beneficial effect on overall EFs (SMD = -0.68, 95% CI: -0.91 to -0.45) and a moderate-to-large effect on the specific domains of EFs. The pooled effects on overall core symptoms and EFs were not significantly modified by study population (children or adolescents), exercise session duration (≤50 or >50 minutes per session, median), or total exercise sessions (<24 or ≥24 sessions, median). CONCLUSIONS CEIs have small-to-moderate beneficial effects on overall core symptoms and EFs in children and adolescents with ADHD.
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Affiliation(s)
| | - Zhijuan Jin
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | | | | | - Yiwen Zhang
- Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Minghui Quan
- School of Exercise and Health.,Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, China
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Factors Contributing to Employment Status over Time for Caregivers of Young People with Mental Health Disorders. Healthcare (Basel) 2022; 10:healthcare10081562. [PMID: 36011219 PMCID: PMC9408201 DOI: 10.3390/healthcare10081562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 11/23/2022] Open
Abstract
This study utilized the conservation of resources theory to guide the examination of employment outcomes for caregivers of children with emotional and/or behavioral disorders. The sample included 2455 caregivers whose children received services through federally funded systems of care. Of special interest was whether receiving services and supports predicted change in employment status. We examined change in employment between baseline data collection and the six-month follow-up including: (1) gaining employment, and (2) retaining employment. Findings indicated that the relationship between service/supports and caregiver employment differed depending on initial employment status, and type of service received. Accessing any service was associated with gaining employment. For families who accessed any services, receiving behavioral aide services was associated with gaining employment. Caregivers of children who used residential services were less likely to lose employment. Several child, caregiver, and demographic variables also predicted employment status over time. Taken together, the findings suggest that caregivers of children with emotional and behavioral challenges are at risk for downward cycles of resource loss, and that services and supports have the potential to mitigate that risk.
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Swann-Thomsen HE, Lindsay R, Rourk S, Hofacer R, Nguyen E. National Survey Data to Evaluate Case Management Services: A Systematic Review on Care Coordination Using the National Survey of Children With Special Health Care Needs. Prof Case Manag 2022; 27:124-140. [PMID: 35363658 DOI: 10.1097/ncm.0000000000000551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hillary E Swann-Thomsen
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Ryan Lindsay
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Seth Rourk
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Rylon Hofacer
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
| | - Elaine Nguyen
- Hillary E. Swann-Thomsen, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. She is currently an applied research scientist at St. Luke's Health System. Her research focuses on improving quality of care in vulnerable patient populations
- Ryan Lindsay, PhD, MPH, is an associate professor in the Department of Community and Public Health at Idaho State University with interests in the household production of health, healthcare access, and the interaction between substance use and infectious diseases. His research highlights the health of addicted, deaf, homeless, immigrant, and sex worker populations
- Seth Rourk, PharmD, was a student pharmacist at Idaho State University College of Pharmacy during the time of this work. He is currently an instructor and affiliate faculty in the Department of Pharmacy Practice at Idaho State University
- Rylon Hofacer, PhD, was a postdoctoral fellow in the Idaho Center for Health Research at Idaho State University during the time of this work. He is currently a healthcare economics analyst at Blue Cross of Idaho
- Elaine Nguyen, PharmD, MPH, is an assistant professor in the Department of Pharmacy Practice at Idaho State University. She is interested in chronic disease management, health services-related research, and the use of technology in patient care
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Morton B, Damato EG, Ciccarelli MR, Currie J. Care Coordination for Children with Special Healthcare Needs Anticipating Transition: A Program Evaluation. J Pediatr Nurs 2021; 61:7-14. [PMID: 33711643 DOI: 10.1016/j.pedn.2021.02.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/23/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Nearly 20% of U.S. children have special healthcare needs (CSHCN). Difficulties experienced with navigating the array of services for these children has highlighted the value of care coordination to improve care, reduce costs and increase satisfaction. This study evaluated the services delivered within a care coordination program at a transition consultation center for CSHCN. It also compared the advancement of youth by age group toward graduation criteria. DESIGN AND METHODS Using a program evaluation method, data were collected via a retrospective chart review. The convenience sample included clinical records from 100 patients aged 11-22 who had a chronic disease or disability. RESULTS The comparison of services for those with diagnoses of autism spectrum disorder, cerebral palsy and Down syndrome were uniformly high in supporting primary care and health care financing. Medicaid waiver assistance was provided more frequently to younger adolescents while older adolescents more commonly received support in all other graduation criteria, including primary and specialty care, healthcare financing and decision-making supports. CONCLUSIONS Youth served in a transition care coordination program receive a high volume and broad array of services. There are some variations in the types of services by diagnosis and level of support need. Older youth show greater advancement toward graduation criteria. PRACTICE IMPLICATIONS This in-depth chart review provides a valuable description of the activities of care coordinators serving CSHCN enduring transition. It enables development of targeted strategies for building care coordination programming and sets an example for the design of future research studies on this topic.
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Affiliation(s)
- Beth Morton
- Indiana University School of Nursing, IN USA.
| | - Elizabeth G Damato
- Frances Payne Bolton School of Nursing, Case Western Reserve University, OH USA
| | - Mary R Ciccarelli
- Indiana University School of Medicine, Departments of Medicine and Pediatrics, IN USA
| | - Jackson Currie
- Frances Payne Bolton School of Nursing, Case Western Reserve University, OH USA
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Lindly OJ, Crossman MK, Shui AM, Kuo DZ, Earl KM, Kleven AR, Perrin JM, Kuhlthau KA. Healthcare access and adverse family impact among U.S. children ages 0-5 years by prematurity status. BMC Pediatr 2020; 20:168. [PMID: 32303218 PMCID: PMC7164160 DOI: 10.1186/s12887-020-02058-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 03/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Many children and their families are affected by premature birth. Yet, little is known about their healthcare access and adverse family impact during early childhood. This study aimed to (1) examine differences in healthcare access and adverse family impact among young children by prematurity status and (2) determine associations of healthcare access with adverse family impact among young children born prematurely. METHODS This was a secondary analysis of cross-sectional 2016 and 2017 National Survey of Children's Health data. The sample included 19,482 U.S. children ages 0-5 years including 242 very low birthweight (VLBW) and 2205 low birthweight and/or preterm (LBW/PTB) children. Prematurity status was defined by VLBW (i.e., < 1500 g at birth) and LBW/PTB (i.e., 1500-2499 g at birth and/or born at < 37 weeks with or without LBW). Healthcare access measures were adequate health insurance, access to medical home, and developmental screening receipt. Adverse family impact measures were ≥ $1000 in annual out-of-pocket medical costs, having a parent cut-back or stop work, parental aggravation, maternal health not excellent, and paternal health not excellent. The relative risk of each healthcare access and adverse family impact measure was computed by prematurity status. Propensity weighted models were fit to estimate the average treatment effect of each healthcare access measure on each adverse family impact measure among children born prematurely (i.e., VLBW or LBW/PTB). RESULTS Bivariate analysis results showed that VLBW and/or LBW/PTB children generally fared worse than other children in terms of medical home, having a parent cut-back or stop working, parental aggravation, and paternal health. Multivariable analysis results only showed, however, that VLBW children had a significantly higher risk than other children of having a parent cut-back or stop work. Adequate health insurance and medical home were each associated with reduced adjusted relative risk of ≥$1000 in annual out-of-pocket costs, having a parent cut-back or stop work, and parental aggravation among children born prematurely. CONCLUSIONS This study's findings demonstrate better healthcare access is associated with reduced adverse family impact among U.S. children ages 0-5 years born prematurely. Population health initiatives should target children born prematurely and their families.
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Affiliation(s)
- Olivia J Lindly
- Department of Health Sciences, Northern Arizona University, 1100 S. Beaver Street, Room 488, Flagstaff, AZ, 86011, USA.
| | | | - Amy M Shui
- Massachusetts General Hospital Biostatistics Center, Boston, MA, USA
| | - Dennis Z Kuo
- Department of Pediatrics, University at Buffalo, Buffalo, New York, USA
| | - Kristen M Earl
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Amber R Kleven
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - James M Perrin
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Karen A Kuhlthau
- Division of General Academic Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Nasol E, Lindly O, Chavez AE, Zuckerman KE. Unmet Need and Financial Impact Disparities for US Children with ADHD. Acad Pediatr 2019; 19:315-324. [PMID: 30201517 PMCID: PMC7440657 DOI: 10.1016/j.acap.2018.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The 5.1million US children with attention-deficit/hyperactivity disorder (ADHD) have pronounced needs in education, occupational and speech therapy, and medical and behavioral treatments. Given known associations of ADHD diagnosis with race/ethnicity and parent education, this study aimed to assess how measures of socioeconomic status correlate with both adverse family financial impact of ADHD and disparities in unmet treatment need for ADHD. METHODS Secondary analysis of children ages 8 to 17years whose households participated in the 2014 National Survey of the Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome. Using bivariate testing, we examined associations among measures of socioeconomic status with unmet ADHD treatment need and family financial impact. Logistic regression models estimated the odds of having unmet treatment need, adjusting for demographic factors and family financial impact. RESULTS Among US school-aged children with a current ADHD diagnosis, 44.3% experienced an adverse family financial impact from ADHD, and 11.6% had unmet need for ADHD treatment. Children with younger age at first ADHD diagnosis were more likely to experience adverse family financial impact. Children from non-English-speaking households were less likely to report unmet need compared to those from primarily English-speaking households. The adjusted odds of unmet need were twice as great among those who reported adverse family financial impact. CONCLUSION Deeper understanding of the influence of the household language is important in ADHD needs assessments. Considering overall family financial circumstances may also be pertinent, particularly as children age, because earlier diagnosiswas associated with adverse financial outcomes. These findings could shape future clinic policies for targeting community resources.
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Affiliation(s)
| | | | | | - Katharine E. Zuckerman
- Division of General Pediatrics, Doernbecher Children’s Hospital, Oregon Health & Science University, 707 SW Gaines Street, Mail Code CDRCP, Portland, OR 97239
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Yoo A, Kim M, Ross MM, Vaughn-Lee A, Butler B, dosReis S. Engaging Caregivers in the Treatment of Youth with Complex Developmental and Mental Health Needs. J Behav Health Serv Res 2018. [DOI: 10.1007/s11414-018-9604-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Bauer NS, Azer N, Sullivan PD, Szczepaniak D, Stelzner SM, Downs SM, Carroll AE. Acceptability of Group Visits for Attention-Deficit Hyperactivity Disorder in Pediatric Clinics. J Dev Behav Pediatr 2017; 38:565-572. [PMID: 28816910 PMCID: PMC5657442 DOI: 10.1097/dbp.0000000000000492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children with attention-deficit hyperactivity disorder (ADHD) have ongoing needs that impair home and school functioning. Group visit models are a promising way to deliver timely parenting support but family and provider acceptance has not previously been examined. The objective was to describe the acceptability of ADHD group visits in busy pediatric clinics based on caregivers, child participants and facilitators. METHODS Data were analyzed from school-age children and caregivers who participated in one of two 12-month long randomized controlled studies of the ADHD group visit model from 2012 to 2013 or 2014 to 2015. Feedback was obtained using semi-structured questions at each study end, by telephone or at the last group visit. Sessions were audio-recorded, transcribed and themes were extracted by participant type. RESULTS A total of 34 caregivers, 41 children and 9 facilitators offered feedback. Caregivers enjoyed the "support group" aspect and learning new things from others. Caregivers reported improved understanding of ADHD and positive changes in the relationship with their child. Children were able to recall specific skills learned including how skills helped at home or school. Facilitators acknowledged systems-level challenges to offering group visits but felt the group format helped increase understanding of families' needs, improved overall care, and provided innovative ways to engage with families. CONCLUSION The majority of comments from families and facilitators highlighted a variety of benefits of the use of a group visit model for ADHD chronic care. Despite systems-level barriers to implementation, families and facilitators felt the benefits outweighed the challenges.
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Affiliation(s)
- Nerissa S. Bauer
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Nina Azer
- Department of Pediatrics, University of Kentucky, Lexington, KY
| | - Paula D. Sullivan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Dorota Szczepaniak
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Stephen M. Downs
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Aaron E. Carroll
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
- Department of Pediatrics, Indiana University School of Medicine, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, IN
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