Social Networks, Caregiver Strain, and Utilization of Mental Health Services Among Elementary School Students at High Risk for ADHD

Bussing, Regina; Zima, Bonnie T.; Gary, Faye A.; Mason, Dana M.; Leon, Christina E.; Sinha, K. K.; Garvan, Cynthia Wilson

doi:10.1097/01.chi.0000046876.27264.bf

Cited by 125 publications

(175 citation statements)

References 38 publications

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“…36 Although much of the literature on SDM has focused on doctor-patient communication, SDM in ADHD extends beyond this dyad. Building on previous work that characterized the influence of social networks on families with ADHD 37 and the difficulties of clinicians in communicating with other professionals to coordinate care, 31 our findings underscore the often-central role of extended-family members, friends, and professionals from the school and mental health system in SDM. However, they rarely are active participants in the medical encounter.…”

Section: Discussionmentioning

confidence: 94%

Contrasting Parents' and Pediatricians' Perspectives on Shared Decision-Making in ADHD

et al. 2011

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WHAT'S KNOWN ON THIS SUBJECT: Shared decision-making (SDM) is recommended when multiple evidence-based treatments exist and families value options differently. Although national guidelines prioritize SDM in attention-deficit/ hyperactivity disorder, little is known regarding how parents and clinicians understand and implement SDM in practice. WHAT THIS STUDY ADDS:We found that practical barriers limit the consideration of evidence-based options in SDM, key participants often are excluded from the process, and, although parents and clinicians view SDM favorably, they understand SDM differently. Implications for clinical practice are discussed. abstract OBJECTIVE:The goal was to compare how parents and clinicians understand shared decision-making (SDM) in attention-deficit/hyperactivity disorder (ADHD), a prototype for SDM in pediatrics. METHODS:We conducted semi-structured interviews with 60 parents of children 6 to 12 years of age with ADHD (50% black and 43% college educated) and 30 primary care clinicians with varying experience. Open-ended interviews explored how pediatric clinicians and parents understood SDM in ADHD. Interviews were taped, transcribed, and then coded. Data were analyzed by using a modified grounded theory approach. RESULTS: Parents and clinicians both viewed SDM favorably. However, parents described SDM as a partnership between equals, with physicians providing medical expertise and the family contributing in-depth knowledge of the child. In contrast, clinicians understood SDM as a means to encourage families to accept clinicians' preferred treatment. These findings affected care because parents mistrusted clinicians whose presentation they perceived as biased. Both groups discussed how real-world barriers limit the consideration of evidence-based options, and they emphasized the importance of engaging professionals, family members, and/or friends in SDM. Although primary themes did not differ according to race, white parents more commonly received support from medical professionals in their social networks. CONCLUSIONS: Despite national guidelines prioritizing SDM in ADHD, challenges to implementing the process persist. Results suggest that, to support SDM in ADHD, modifications are needed at the practice and policy levels, including clinician training, incorporation of decision aids and improved strategies to facilitate communication, and efforts to ensure that evidence-based treatment is accessible.

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Section: Discussionmentioning

confidence: 94%

Contrasting Parents' and Pediatricians' Perspectives on Shared Decision-Making in ADHD

et al. 2011

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“…Factors that contribute to low medication adherence, such as dysfunctional schools, irregular parental work schedules, and lower social support, are prevalent among minority children with ADHD (Bussing et al 2003;Guevara et al 2005). Literature on ADHD medication use among minorities emphasizes cultural norms that contribute to lower medication adoption (dosReis et al 2006;Eiraldi et al 2006), yet it is also likely that that some minority families are willing to start a child on medication but fail to continue treatment because of difficulty adhering to the treatment regimen.…”

Section: Introductionmentioning

confidence: 99%

“…These medications have displaced shorter-acting treatments that require two or more daily administrations (Stein 2004). Simplifying medication treatment makes it easier to establish a treatment routine, leading to more habitual and automatic use (Chacko et al 2010). Long-acting medication users have shown increased adherence compared with short-acting users (Adler and Nierenberg 2010).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Long-Acting Medications on Attention-Deficit/Hyperactivity Disorder Treatment Disparities

Saloner

Fullerton

McGuire

2013

Journal of Child and Adolescent Psychopharmacology

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Objective: Long-acting stimulants have increased medication adherence for many children diagnosed with attention deficit/hyperactivity disorder (ADHD), but it is unknown whether the increase has been similar across racial/ethnic groups. Our objective was to determine whether differences in medication utilization and adherence among white, black, and Hispanic ADHD-diagnosed children and adolescents narrowed following the introduction of long-acting stimulants in the 1990s. Methods: We conducted a retrospective analysis of Florida Medicaid claims data from fiscal years 1996-2005. At each of three cross sections, we identified children and adolescents 3-17 years of age with at least two claims with an ADHD diagnosis. We used linear regression to model disparities over the study period in utilization of any ADHD medications (utilization of long-acting medication specifically) and medication adherence, and identified patient level, treatment setting, and geographic contributors to disparities. Results: Although ADHD medication utilization was lower for ADHD-diagnosed minorities than whites in all years, minorities were as likely as whites to switch to long-acting medications. The increase in prescribed days following longacting medication diffusion was comparable for white and black medication users (40 and 43 days, respectively), but lower for Hispanics (27 days). Geography and provider setting helped to explain disparities in medication utilization overall, but disparities in adherence were not explained by any of the covariates. Conclusions: Despite equivalent switching to long-acting medications in the study period, minorities continued to utilize all ADHD medications less than did whites, and for shorter periods. Provider setting helps explain the ADHD medication utilization gap. High-volume, minority-serving providers are potential targets for future interventions related to improved communication about medication and follow-up after medication initiation.

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“…sin embargo, no sólo el funcionamiento familiar se relaciona con el ajuste social y psicológico, las relaciones extra familiares y variables atributivas (edad, sexo, estatus económico, etc. ), sino que también otras lo hacen (Bussing et al, 2003). en particular, la red social, y su tamaño, está asociada con diferentes padecimientos psiquiátri-cos y la severidad de éstos (Pattison, 1977) o con desajuste social (shinn, KnicKman & Weitzman, 1991); otros estudios de carácter epidemiológi-co prospectivo, a gran escala (Berkman & syme, 1979;House, landis & umberson, 1988) reportan que el tamaño de red predice mayor riesgo de muerte en sujetos con pocos vínculos sociales.…”

Section: Introductionunclassified

Dinámica de red social y alteración psicológica en adolescentes con ausencia de familia de origen

Quiróz

Valero

2008

Divers.: Perspect. Psicol.

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universidad nacional autónoma de México, iztacala, MéxicoResumen el objetivo fue realizar un estudio en muestras de adolescentes que vivieran con sus familias y que no vivieran con ellas, en el cual se analizarán las variables de red y de alteración psicológica (depresión) y probar el valor relativo de las propiedades dinámicas de la red para describir y predecir alteración emocional. Participaron 61 adolescentes, 31 del reclusorio para menores infractores y 30 estudiantes. los adolescentes recluidos muestran más depresión que los estudiantes y estos últimos obtuvieron puntajes más altos en el índice de relaciones familiares y en la calidad de red. esto indica que cuando algún componente de la red social se ve alterado, hay más propensión a que se presenten problemas de alteración psicológica, como la depresión, lo que tiene impacto en las medidas de red social.Palabras clave: red social, calidad de red, depresión, adolescentes, familia de origen.

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Social Networks, Caregiver Strain, and Utilization of Mental Health Services Among Elementary School Students at High Risk for ADHD

Cited by 125 publications

References 38 publications

Contrasting Parents' and Pediatricians' Perspectives on Shared Decision-Making in ADHD

Contrasting Parents' and Pediatricians' Perspectives on Shared Decision-Making in ADHD

The Impact of Long-Acting Medications on Attention-Deficit/Hyperactivity Disorder Treatment Disparities

Dinámica de red social y alteración psicológica en adolescentes con ausencia de familia de origen

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