Racial-ethnic disparities in diagnosis and treatment of Attention Deficit/Hyperactivity Disorder (ADHD) suggest that all children with ADHD are at risk for poor quality of care. In order to better understand these disparities in ADHD care quality, Dr. Eugenia Chan, a developmental-behavioral pediatrician, is submitting this revised applications for a Mentored Patient-Oriented Career Development Award (K23) to develop a cross-cultural, patient-centered approach for assessing quality of primary care management of children with ADHD. The overall goals are to develop a conceptual understanding of barriers to effective care from patient and family perspectives, to understand how and why these problems vary across cultural groups, and to develop instruments and methods to measure these patient-centered processes of care and to guide interventions to improve clinical care and outcomes for children with ADHD.
The specific aims are to (1) develop a patient-centered model of ADHD care quality by investigating similarities and differences in African-American, Chinese-American, and European-American family experiences of ADHD care;(2) develop and validate a parent survey of patient-centered indicators of ADHD care quality that are sensitive to cross-cultural values regarding care for ADHD;and (3) test the survey in a diverse, primary care patient population to assess psychometric properties and identify disparities in patient-centered ADHD care quality. The results of this project will lead directly to future applications to (1) investigate relationships among patient-centered quality assessments, evidence-based quality indicators, and ADHD outcomes, (2) identify disparities in primary care management of ADHD, and (3) develop and implement targeted interventions to improve disparities in quality of ADHD care. The candidate has demonstrated skills as a developmental- behavioral pediatrician and junior health services researcher. The multidisciplinary education plan focuses on acquiring strong theoretical background and skills in qualitative methods, culture and disparities in mental health, advanced biostatistics, and measurement-based quality assessment and quality improvement. With an outstanding team of mentors and consultants, Dr. Chan's detailed, focused education and research plan will enable her to achieve her long-term goal of becoming a successful independent investigator devoted to understanding and reducing disparities in quality of care for children with mental health conditions.