Attention Deficit Hyperactivity Disorder (ADHD), considered the most common child psychiatric condition, has only been minimally examined from a health services perspective. New efficacy data on multimodal treatments are forthcoming, but before we can mount effectiveness studies of these interventions, we must identify salient barriers to care, determine the magnitude of unmet need, learn how to best target affected children, and gather the viewpoints of relevant stakeholders on what interventions will work in specific contexts. This study therefore has the following specific aims: 1) to identify barriers to detection and access to services for ADHD, on the level of family and child, the school system, and health care providers, through complementary qualitative and quantitative research methods; 2) to determine the extent to which children with ADHD receive services across sectors (general health, mental health, education, informal and self-care), comparing the findings to suggested practice parameters for ADHD, and examining the associations between services use patterns and characteristics of the child, family, social network, school system, and of health care providers; and 3) to determine the implications of findings from this study for future context-specific interventions from the perspectives of multiple stakeholders, through focus group interview methods. To address these aims, we will use a combination of primary data collected on a representative sample of children enrolled in grades K through 5 in a Florida school district, and secondary data from the school district. Primary data will provide information on disorders, predisposing and barrier characteristics, and service use in the health and self-care sector. Secondary data will yield information on school performance and school service use. Profiles of help-seeking and of service use will be established at the individual child level, and characteristics of the school environment will be determined at the school level. The study findings will subsequently be presented in focus group interviews to relevant stakeholders to determine the implications for service delivery and for future effectiveness trials from their perspectives.
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