title: Student-Perceived School Climate Is Associated With ADHD Medication Treatment Among Adolescents in Medicaid.
abstract: The objective of this study was to evaluate the relationship between school climate and ADHD medication treatment among adolescents in Medicaid in Georgia.
  
  
  
  School climate and Medicaid claims data were aggregated for 159 GA counties. County-level school climate percentile and medicated ADHD prevalence were calculated. The t tests and regression models evaluated the relationship between school climate, medicated ADHD, and demographics, weighted by county population. Poorer 2008 school climate (<25th percentile) was regressed on 2011 medicated ADHD prevalence, controlling for potential confounders.
  
  
  
  The prevalence of medicated ADHD was 7.8% among Medicaid-enrolled GA adolescents. The average county-level prevalence of medicated ADHD was 10.0% ( SD = 2.9%). Poorer school climate was associated with lower rates of medicated ADHD ( p < .0001); along with demographics, these factors accounted for 50% of the county variation in medicated ADHD.
  
  
  
  School climate is associated with medicated ADHD among adolescents in Medicaid. Additional research may reveal whether high medicated ADHD may reflect a lack of access to non-pharmacological therapies in some communities.
authors.affiliation: 1 Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Susanna N
authors.initials: SN
authors.lastname: Visser
authors.affiliation: 2 Georgia Department of Education, Atlanta, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Kramer
authors.affiliation: 3 Georgia State University, Atlanta, USA.
authors.forename: Angela B
authors.initials: AB
authors.lastname: Snyder
authors.affiliation: 4 Substance Abuse Mental Health Services Administration, Rockville, MD, USA.
authors.forename: Joyce
authors.initials: J
authors.lastname: Sebian
authors.affiliation: 2 Georgia Department of Education, Atlanta, USA.
authors.forename: Garry
authors.initials: G
authors.lastname: McGiboney
authors.affiliation: 5 University of Illinois at Chicago, USA.
authors.forename: Arden
authors.initials: A
authors.lastname: Handler
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D015995:Prevalence; D012574:Schools; D013334:Students / Q000706:statistics & numerical data*; D014481:United States
chemical_list: D000697:Central Nervous System Stimulants
keywords: ADHD; behavioral problems; health care utilization; medication treatment; school climate