Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care.

Content Provider	Europe PMC
Author	Baweja, Raman Soutullo, Cesar A Waxmonsky, James G
Copyright Year	2021
Abstract	Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8717033&blobtype=pdf
Journal	World Journal of Psychiatry [World J Psychiatry]
Volume Number	11
DOI	10.5498/wjp.v11.i12.1206
PubMed Central reference number	PMC8717033
Issue Number	12
PubMed reference number	35070771
e-ISSN	22203206
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2021-12-19
Access Restriction	Open
Rights License	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/ ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Attention deficit hyperactivity disorder Treatment engagement Barriers Interventions Children Adolescents
Content Type	Text
Resource Type	Article
Subject	Psychiatry and Mental Health