ArticlePediatrics2021
Six Stages of Engagement in ADHD Treatment Described by Diverse, Urban Parents.
Article in Pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05796427 (Testing a Novel ADHD Engagement Intervention "START" to Improve Access to Treatment), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Testing a Novel ADHD Engagement Intervention "START" to Improve Access to Treatment
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Barriers and Enablers of Service Access and Utilization for Children and Adolescents With Attention Deficit Hyperactivity Disorder: A Systematic Review.Journal of attention disorders · 2024Pooled it
- Practitioner Review: It's time to bridge the gap - understanding the unmet needs of consumers with attention-deficit/hyperactivity disorder - a systematic review and recommendations.Journal of child psychology and psychiatry, and allied disciplines · 2023Pooled it
- Parent Perspectives on Barriers to Behavioral Health Services for Children With ADHD.Journal of attention disorders · 2026Article
- Promoting Equitable Engagement in Attention-Deficit/Hyperactivity Disorder Care.Pediatric annals · 2025Article
- Struggling to be heard: A scoping review of user participation in ADHD mental healthcare for children and adolescents.Scandinavian journal of child and adolescent psychiatry and psychology · 2025Review
- Incidence of Attention-Deficit/Hyperactivity Disorder Between 2016 and 2023: A Retrospective Cohort.Psychiatric research and clinical practice · 2025Article
- Article
- "If he doesn't buy in, it's a waste of time": Perspectives from diverse parents and adolescents on engaging children in ADHD treatment.Child psychiatry and human development · 2024Article
- Parental ADHD knowledge and medical visit status of school-aged children in Shanghai.Child and adolescent psychiatry and mental health · 2024Article
- Engaging Youth Voice and Family Partnerships to Improve Children's Mental Health Outcomes.Child and adolescent psychiatric clinics of North America · 2024Review
- Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.Academic pediatrics · 2023Review
- The Toll of COVID-2019 on Diverse, Urban Children With Attention Deficit Hyperactivity Disorder and Their Families: A Case Series.Clinical pediatrics · 2022Article
- ADHD Prevalence Rose, Yet Disparities Remain: Commentary on the 2022 National Survey of Children's Health.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in children. Although ADHD is treatable, barriers remain to engagement in treatment, especially among socioeconomically disadvantaged and racial and ethnic minority families. Our goal was to examine the process by which families engage in ADHD treatment and to identify targets for an intervention to improve engagement in care.
methodsWe conducted in-depth semistructured qualitative interviews with 41 parents of diverse youth aged 3 to 17 years old in treatment of ADHD at an urban safety net hospital. Parents were asked about their journey through diagnosis and treatment, community attitudes about ADHD, and other factors influencing treatment access and decision-making. Transcripts were analyzed by using thematic analysis.
resultsOf children with ADHD, 69.2% were male, 57.7% were Black or African American, and 38.5% were of Hispanic, Latino, or Spanish origin. Parents were 92.7% female, were 75.6% English speaking, and had a median income of $20 000. Parents described 6 stages to the process of engaging in care for their child's ADHD, which unfolded like a developmental process: (1) normalization and hesitation, (2) fear and stigmatization, (3) action and advocacy, (4) communication and navigation, (5) care and validation, and (6) preparation and transition. Barriers often occurred at points of stage mismatch between parents and providers and/or systems. Difficulty resolving an earlier stage interfered with the progression through subsequent stages.
conclusionsThe 6 stages framework could be used to develop new strategies to measure engagement and to design family-centered interventions to facilitate engagement in ADHD treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.