Department 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.
Department of Pediatrics (H Bush), Cincinnati Children...s Hospital Medical Center, Ohio.
Acad Pediatr. 2023 Aug;23(6):1175-1186. doi: 10.1016/j.acap.2023.03.014. Epub 2023 Mar 28.
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.
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.
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.
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.
尽管有证据表明持续治疗对注意缺陷多动障碍（ADHD）的管理很重要，但少数族裔儿童的 ADHD 治疗开始和依从性仍然不理想。本研究的目的是探讨少数族裔儿童 ADHD 治疗开始/依从性的障碍和促进因素，以便进一步为我们的家庭导航干预措施提供信息。
使用虚拟平台，我们完成了 7 次焦点小组会议（总人数=n=26）和 6 次个别访谈，参与者来自 4 个利益相关者群体：有 ADHD 儿童经验的照顾者、新诊断为 ADHD 的儿童的照顾者、家庭导航员和照顾 ADHD 儿童的临床医生。所有照顾者都被认定为黑人和/或拉丁裔。为每个利益相关者群体分别举行了会议，照顾者可以选择参加英语或西班牙语会议。使用主题分析策略，对 ADHD 治疗开始和/或依从性的障碍和促进因素进行了焦点小组/访谈数据编码，并在各群体中确定了主题。
少数族裔儿童 ADHD 治疗开始和/或依从性的主要障碍包括缺乏来自学校/医疗保健/家庭成员的支持、文化障碍、资源有限、获取途径有限以及对治疗的担忧，参与者的认可程度存在差异。报告的促进因素包括照顾者有 ADHD 经验、强烈支持、获得资源以及看到他们的孩子在治疗后功能改善。
照顾者对 ADHD 的经验、知识、支持和获得资源有助于少数族裔儿童的 ADHD 治疗。这项研究的结果有可能通过开发文化定制的多管齐下的干预措施来改善少数族裔儿童的 ADHD 治疗开始/依从性和结果。
