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Acceptability of Group Visits for Attention-Deficit Hyperactivity Disorder in Pediatric Clinics

Bauer, Nerissa S. MD, MPH*,†; Azer, Nina MD; Sullivan, Paula D. PhD§; Szczepaniak, Dorota MD§; Stelzner, Sarah M. MD; Downs, Stephen M. MD, MS*,†; Carroll, Aaron E. MD, MS¶,†

Journal of Developmental & Behavioral Pediatrics: October 2017 - Volume 38 - Issue 8 - p 565–572
doi: 10.1097/DBP.0000000000000492
Original Articles
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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.

This article has supplementary material on the web site: www.jdbp.org.

*Section of Children's Health Services Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN;

Center for Health Services Research, Regenstrief Institute Inc, Indianapolis, IN;

Department of Pediatrics, University of Kentucky, Lexington, KY;

§Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN;

Eskenazi Medical Group, Indianapolis, IN;

Section of Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN.

Address for reprints: Nerissa S. Bauer, MD, MPH, 410 W. 10th St, Suite 2000, Indianapolis, IN 46202; e-mail: nsbauer@iu.edu.

Funding was provided by R24 funding (R24-HS022434-01) from the Agency for Healthcare Research and Quality (PI: A. E. Carroll).

Disclosure: None of the authors have any financial relationship to disclose. The ADHD Group Visit Curriculum was developed by 2 of the authors (N.S.B. and P.D.S.); the remaining authors do not have any conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jdbp.org).

See the video abstract at jdbp.org

Received January , 2017

Accepted June , 2017

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