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Insa I, Alda JA, Chamorro M, Espadas M, Huguet A. Difference in Psychic Distress Lived by Parents With ADHD Children and Parents With Healthy Children: Focus on Gender Differences. J Atten Disord 2021; 25:332-339. [PMID: 30070594 DOI: 10.1177/1087054718790010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: ADHD has a complex and negative influence on the family system. The aim of this study was to analyze the perception of emotional distress in a group of parents of children with ADHD. Method: A sample was recruited from the public health system ADHD Unit at Sant Joan de Déu Hospital (Barcelona). The parents of 60 children with newly diagnosed ADHD and the parents of 60 healthy children were included. Results: Higher levels of distress in families with children with ADHD were seen. The distress is present in both parents, with a higher prevalence in the mothers group. A positive correlation was found between ADHD symptoms in the children and the distress reported by parents. A three times higher rate of separations and divorce among parents of children with ADHD was seen. Conclusion: ADHD in children and adolescents increases the emotional distress reported by parents, mainly related to the severity of symptoms present in the children.
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Affiliation(s)
- Inmaculada Insa
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain
| | - José A Alda
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain.,Children and Adolescent Mental Health Research Group. Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain
| | - Marta Chamorro
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain
| | - Marta Espadas
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain
| | - Anna Huguet
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Spain.,Children and Adolescent Mental Health Research Group. Institut de Recerca Sant Joan de Déu, Santa Rosa, Esplugues de Llobregat, Spain
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Laugesen B, Lauritsen MB, Jørgensen R, Sørensen EE, Rasmussen P, Grønkjær M. The Complexities of Everyday Life and Healthcare Utilization in Danish Children With ADHD: A Mixed Methods Study. J Pediatr Nurs 2020; 52:e33-e41. [PMID: 32008832 DOI: 10.1016/j.pedn.2020.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To explore and describe everyday life and hospital-based healthcare experiences and utilization in families of children with ADHD in Denmark. DESIGN AND METHODS The present work is a multistage, mixed methods study. The design consists of three individual studies: a meta-synthesis, a focused ethnographic study, and a historical cohort study. RESULTS The integrated findings show that: 1) parental stressors affect everyday life and hospital-based service use; 2) parents have concerns for their child from early childhood and fight to have their concerns recognized; and 3) healthcare professionals are important for parents to navigate the persistent challenges of everyday life. CONCLUSIONS Having a child with ADHD pervades everyday life and children with ADHD use more medical and psychiatric services in hospitals during the first 12 years of life than children without ADHD. The findings demonstrate a vulnerable everyday life experience and highlight the importance of the families being recognized, accepted, and respected in hospital-based healthcare services from early childhood. PRACTICE IMPLICATIONS Healthcare professionals need to recognize the challenges the family of a child with ADHD faces and to acknowledge that ADHD pervades all aspects of everyday life and all other healthcare issues. It is important for healthcare professionals, regardless of specialty, to engage with individual families and to positively contribute to the medical and psychiatric healthcare experience.
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Affiliation(s)
- Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark.
| | | | - Rikke Jørgensen
- Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg University Hospital, Denmark
| | - Erik Elgaard Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
| | | | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark
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Bauer NS, Ofner S, Moore C, Lynch D, Wiehe SE, Downs SM, Carroll AE, Kronenberger WG. Assessment of the Effects of Pediatric Attention Deficit Hyperactivity Disorder on Family Stress and Well-Being: Development of the IMPACT 1.0 Scale. Glob Pediatr Health 2019; 6:2333794X19835645. [PMID: 30906819 PMCID: PMC6421607 DOI: 10.1177/2333794x19835645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 12/31/2018] [Indexed: 11/16/2022] Open
Abstract
Medications may lessen core symptoms of attention deficit hyperactivity disorder (ADHD), yet families continue to report stress and have a low quality of life. Primary care providers manage almost half of all children with ADHD but do not have a brief measure to assess ADHD impacts on family in the context of everyday family life. The IMPACT (Impact Measure of Parenting-Related ADHD Challenges and Treatment) 1.0 Scale was codeveloped with input from parent advisors and administered to 79 parents of children with ADHD. Exploratory factor analysis, correlations with validated instruments, and test-retest reliability were examined. Exploratory factor analysis resulted in 4 subscales (Misbehavior, Siblings, Time, School), which demonstrated moderate to high test-retest reliability. Scale domains were related to severity and change in ADHD symptoms. Significant correlations were found between IMPACT scores, adaptive functioning in the home, and ADHD-related quality of life. The IMPACT 1.0 Scale provides a novel, reliable, and valid method to assess family impact of ADHD.
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Affiliation(s)
- Nerissa S Bauer
- Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc, Indianapolis, IN, USA
| | | | | | | | - Sarah E Wiehe
- Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc, Indianapolis, IN, USA
| | - Stephen M Downs
- Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc, Indianapolis, IN, USA
| | - Aaron E Carroll
- Indiana University, Indianapolis, IN, USA.,Regenstrief Institute, Inc, Indianapolis, IN, USA
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Abstract
OBJECTIVE To understand how adverse childhood experiences (ACEs) are associated with co-occurring physical, mental and developmental problems during early childhood. METHOD A subsample of 19,957 children aged 2-5 years were selected from the 2011-2012 National Survey for Child Health. Outcomes included 18 health conditions organized in singular condition domains (physical, mental, and developmental), and combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). Predictors included 8 ACEs (divorce of a parent, death of a parent, exposure to domestic violence, living with someone with a drug or alcohol abuse problem, household member with a mental illness, parent incarceration, neighborhood violence, discrimination). Multivariable logistic regression was performed controlling for demographic characteristics, having a personal doctor, health insurance coverage, and seeing a health care professional in the previous year. RESULTS Experiencing 3 or more ACEs before the age of 5 years was associated with increased likelihood of nearly every co-occurring condition combination across 3 domains of health. Most notably, experiencing 3 or more ACEs was also associated with a 2-fold increase in likelihood of having ≥1 physical condition and ≥1 developmental condition, a 9-fold increase in likelihood of having ≥1 mental and ≥1 developmental condition, and a 7-fold increase in likelihood of having ≥1 physical, ≥1 mental, and ≥1 developmental condition. CONCLUSION This study demonstrates that we can identify the health effects of adversity quite early in development and that management should include communication between both health care and early childhood education providers.
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Bauer NS, Azer N, Sullivan PD, Szczepaniak D, Stelzner SM, Downs SM, Carroll AE. Acceptability of Group Visits for Attention-Deficit Hyperactivity Disorder in Pediatric Clinics. J Dev Behav Pediatr 2017; 38:565-572. [PMID: 28816910 PMCID: PMC5657442 DOI: 10.1097/dbp.0000000000000492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children with attention-deficit hyperactivity disorder (ADHD) have ongoing needs that impair home and school functioning. Group visit models are a promising way to deliver timely parenting support but family and provider acceptance has not previously been examined. The objective was to describe the acceptability of ADHD group visits in busy pediatric clinics based on caregivers, child participants and facilitators. METHODS Data were analyzed from school-age children and caregivers who participated in one of two 12-month long randomized controlled studies of the ADHD group visit model from 2012 to 2013 or 2014 to 2015. Feedback was obtained using semi-structured questions at each study end, by telephone or at the last group visit. Sessions were audio-recorded, transcribed and themes were extracted by participant type. RESULTS A total of 34 caregivers, 41 children and 9 facilitators offered feedback. Caregivers enjoyed the "support group" aspect and learning new things from others. Caregivers reported improved understanding of ADHD and positive changes in the relationship with their child. Children were able to recall specific skills learned including how skills helped at home or school. Facilitators acknowledged systems-level challenges to offering group visits but felt the group format helped increase understanding of families' needs, improved overall care, and provided innovative ways to engage with families. CONCLUSION The majority of comments from families and facilitators highlighted a variety of benefits of the use of a group visit model for ADHD chronic care. Despite systems-level barriers to implementation, families and facilitators felt the benefits outweighed the challenges.
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Affiliation(s)
- Nerissa S. Bauer
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Nina Azer
- Department of Pediatrics, University of Kentucky, Lexington, KY
| | - Paula D. Sullivan
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | - Dorota Szczepaniak
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN
| | | | - Stephen M. Downs
- Department of Pediatrics, Indiana University School of Medicine, Section of Children’s Health Services Research, Indianapolis, IN
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
| | - Aaron E. Carroll
- Center for Health Services Research, Regenstrief Institute Inc., Indianapolis, IN
- Department of Pediatrics, Indiana University School of Medicine, Section of Pediatric and Adolescent Comparative Effectiveness Research, Indianapolis, IN
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Bright MA, Knapp C, Hinojosa MS, Alford S, Bonner B. The Comorbidity of Physical, Mental, and Developmental Conditions Associated with Childhood Adversity: A Population Based Study. Matern Child Health J 2017; 20:843-53. [PMID: 26694043 DOI: 10.1007/s10995-015-1915-7] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with myriad health conditions and risk behaviors in both adolescents and adults. In this study we examine the association between ACEs and specific physical, mental, and developmental conditions, as well as their comorbidity, in a nationally representative sample of children 0-17 years. METHODS Data from the 2011-2012 National Survey for Child Health (NSCH) were used. A total of 95,677 random-digit-dial interviews with parents of children 0-17 years were conducted across all 50 states and the District of Columbia. Outcomes included singular condition domains (physical, mental, and developmental) as well as combinations of condition domains (e.g., physical plus mental, mental plus developmental, etc.). RESULTS Twenty-three percent of parents reported that their child experienced 1 ACE; 9.2 % experienced 2 ACEs, and 10.3 % experienced three or more. Across all three condition domains and combinations of domains, children who experienced at least one ACE were more likely than children who experienced 0 ACEs to have at least one condition. Additionally, greater ACEs was associated with increased likelihood of at least one condition in each domain and in multiple domains. CONCLUSIONS for practice These findings support the extension of existing family environment screening tools in pediatric practices as well as the establishment of a system for monitoring ACEs in families with multiple or complex conditions.
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Affiliation(s)
- Melissa A Bright
- Institute for Child Health Policy, University of Florida, 1329 SW 16th ST, Gainesville, FL, 32611, USA.
| | - Caprice Knapp
- Department of Health Policy and Administration, The Pennsylvania State University, State College, PA, USA
| | - Melanie S Hinojosa
- Department of Sociology, University of Central Florida, Orlando, FL, USA
| | - Shannon Alford
- Institute for Child Health Policy, University of Florida, 1329 SW 16th ST, Gainesville, FL, 32611, USA
| | - Brandy Bonner
- Institute for Child Health Policy, University of Florida, 1329 SW 16th ST, Gainesville, FL, 32611, USA
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Zhu T, Gan J, Huang J, Li Y, Qu Y, Mu D. Association Between Perinatal Hypoxic-Ischemic Conditions and Attention-Deficit/Hyperactivity Disorder: A Meta-Analysis. J Child Neurol 2016; 31:1235-44. [PMID: 27229008 DOI: 10.1177/0883073816650039] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/16/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder worldwide, but its etiology is still not fully understood. Previous studies have reported that perinatal hypoxic-ischemic conditions may be a potential cause of ADHD. METHODS An online search of potential English studies published before September 2015 was conducted using the PsycINFO, EMBASE, Web of Science, and PubMed databases. The combined odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with random-effects models. RESULTS Ten studies were included, with 45 821 cases and 9 207 363 controls. The metaresults found that the following were associated with ADHD: preeclampsia (OR 1.31; 95% CI 1.26-1.37), an Apgar score <7 at 5 minutes (OR 1.31; 95% CI 1.12-1.54), breech/transverse presentations (OR 1.14; 95% CI 1.06-1.23), and a prolapsed/nuchal cord (OR 1.10; 95% CI 1.06-1.15). CONCLUSION Our results support that perinatal hypoxia-ischemia may contribute to ADHD. However, more clinical studies are warranted.
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Affiliation(s)
- Tingting Zhu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Jing Gan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Jichong Huang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Yafei Li
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Yi Qu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu, Sichuan, China Department of Pediatrics and Neurology, University of California, San Francisco, San Francisco, CA, USA
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Elevated burden for caregivers of children with persistent asthma and a developmental disability. Matern Child Health J 2015; 18:2080-8. [PMID: 24619226 DOI: 10.1007/s10995-014-1455-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To evaluate how having a child with both persistent asthma and a developmental disability (DD) affects caregiver burden and quality of life (QOL). 3-10 year old children with persistent asthma in urban Rochester, NY. Cross-sectional baseline survey (2006-2009). Parent report of autism spectrum disorder or other behavioral disorder requiring medication. Caregiver burden and QOL as measured by scores on previously validated depression, parenting confidence, and asthma-related QOL scales as well as an assessment of competing demands on the caregiver. Bivariate and multivariate regression analyses controlling for caregiver age, education, marital status, race, ethnicity, and child asthma symptom severity. We enrolled 530 children as part of a larger study (response rate: 74; 63 % Black, 73 % Medicaid). Of this sample, 70 children (13 %) were defined as having a DD. There were no differences in asthma symptom severity between children with and without a DD diagnosis. However, even after adjusting for potential confounders, caregivers of children with a DD reported worse scores on the depression (p = .003), parenting confidence (p < .001), and competing demands (p = .013) scales and worse asthma-related QOL (p = .035) compared to caregivers of typically developing children with asthma. Despite having similar asthma symptom severity, caregivers of children with both persistent asthma and a DD diagnosis report more burden and lower QOL compared to that of caregivers of typically developing children and persistent asthma. Further attention to this subgroup is needed to promote optimal support for caregivers.
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Bussing R, Meyer J, Zima BT, Mason DM, Gary FA, Garvan CW. Childhood ADHD Symptoms: Association with Parental Social Networks and Mental Health Service Use during Adolescence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:11893-909. [PMID: 26402692 PMCID: PMC4586714 DOI: 10.3390/ijerph120911893] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/14/2015] [Indexed: 12/17/2022]
Abstract
Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescents’ psychopathology and mental health service utilization, whereas adolescents self-reported their emotional status and ADHD stigma perceptions. Analyses were conducted using ANOVAs and nested logistic regression modeling. Results: Parents of youth with childhood ADHD reported support networks consisting of fewer spouses but more healthcare professionals, and lower levels of support than control parents. Caregiver strain increased with adolescent age and psychopathology. Increased parental network support, youth ADHD symptoms, and caregiver strain, but lower youth stigma perceptions were independently associated with increased service use. Conclusions: Raising children with ADHD appears to significantly impact parental social network experiences. Reduced spousal support and overall lower network support levels may contribute to high caregiver strain commonly reported among parents of ADHD youth. Parental social network experiences influence adolescent ADHD service use. With advances in social networking technology, further research is needed to elucidate ways to enhance caregiver support during ADHD care.
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Affiliation(s)
- Regina Bussing
- Department of Psychiatry, University of Florida, Box 100256, Gainesville, FL 32610-0256, USA.
| | - Johanna Meyer
- School of Psychology, University of Wollongong, Northfields Ave., Wollongong NSW 2522, Australia.
| | - Bonnie T Zima
- UCLA-Semel Institute for Neuroscience and Human Behavior, 10920 Wilshire Blvd. Suite 300, Los Angeles, CA 90024, USA.
| | - Dana M Mason
- Department of Psychiatry, University of Florida, Box 100256, Gainesville, FL 32610-0256, USA.
| | - Faye A Gary
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 2120 Cornell Road, Cleveland, OH 44106, USA.
| | - Cynthia Wilson Garvan
- Office for Research Affairs, College of Nursing, University of Florida, Gainesville, FL 32610, USA.
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Abstract
OBJECTIVE Attention-deficit hyperactivity disorder (ADHD) can impair child health and functioning, but its effects on the family's economic burden are not well understood. The authors assessed this burden in US families of children with ADHD, and the degree to which access to a patient-centered medical home (PCMH) might reduce this burden. METHODS We conducted cross-sectional analyses of 2005-2006 and 2009-2010 National Surveys of Children with Special Health Care Needs, focusing on families of children with ADHD. They defined family economic burden as (1) family financial problems (annual expenses for the child's health care or illness-related financial problems for the family) and/or (2) family employment problems (job loss, work time loss, or failure to change jobs to avoid insurance loss). Relative risk models assessed associations between PCMH and family economic burden, adjusted for child age, sex, ethnicity, ADHD severity, poverty status, caregiver education, and insurance. RESULTS In 2009, 26% of families reported financial problems because of the child's ADHD, 2.1% reported out-of-pocket expenses >5% of income, and 36% reported employment problems. Only 38% reported care that met all 5 criteria for a PCMH (similar to rates in 2005-2006). In multivariable analysis, care in a PCMH was associated with 48% lower relative risk (RR) of financial problems (RR = 0.52, p < .001) and 36% lower relative risk of employment problems (RR = 0.64, p < .001). Among PCMH components, family-centered care and care coordination were more strongly associated with lower burden. CONCLUSIONS The economic burdens of families with ADHD are significant but may be alleviated by family-centered care and care coordination in a medical home.
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