title: Do parent perceptions predict continuity of publicly funded care for attention-deficit/hyperactivity disorder?
abstract: OBJECTIVE
  To examine whether parent perceptions about care (barriers, disorder knowledge, treatment willingness) vary among children who drop out of or stay in publicly funded care for attention-deficit/hyperactivity disorder (ADHD) and to explore whether parent perceptions are predictive of staying in care over time.
  
  
  METHODS
  A longitudinal cohort study of 529 children ages 5 to 11 years receiving care for ADHD in primary care or specialty mental health clinics in a large, countrywide, managed-care Medicaid program. Multiple logistic regression analyses were performed to identify parent perceptions associated with the likelihood of staying in care across three 6-month time intervals, controlling for child and parent demographic characteristics, parental distress, clinical need, and recent special education use.
  
  
  RESULTS
  At least three-fourths of children had at least 1 contact for any mental health care during a 6-month time interval (75%, 85%, 76%). Parent-perceived barriers, ADHD knowledge, and counseling willingness did not predict staying in care, whereas willingness for medication treatment was predictive at baseline. Minority status, nonmarried parent, parental distress, clinical need, and special education use were predictive of staying in care, but mostly during only one 6-month time interval, and their influence varied over time.
  
  
  CONCLUSIONS
  Parent willingness for medication treatment along with several demographic and need factors predicted staying in care but not consistently over time. Future research is needed to develop practical tools for clinicians to elicit parent priorities about ADHD treatment and to integrate them into quality-improvement interventions targeted to improving shared decision-making for longer term ADHD care.
authors: UCLA Center for Health Services and Society, UCLA Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, CA 90024, USA. bzima@mednet.ucla.edu
authors: Bonnie T
authors: BT
authors: Zima
authors: Regina
authors: R
authors: Bussing
authors: Lingqi
authors: L
authors: Tang
authors: Lily
authors: L
authors: Zhang
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D015331:Cohort Studies; D003156:Community Mental Health Services; D004519:Education, Special; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid; D008913:Minority Groups; D010290:Parents; D010349:Patient Compliance; D044469:Racial Groups / Q000706:statistics & numerical data; D015406:Single Parent; D013315:Stress, Psychological / Q000453:epidemiology; D014481:United States / Q000453:epidemiology