Understanding ADHD in Black Adolescents in Urban Schools: A Qualitative Examination of Factors that Influence ADHD Presentation, Coping Strategies, and Access to Care.
Understanding ADHD in Black Adolescents in Urban Schools: A Qualitative Examination of Factors that Influence ADHD Presentation, Coping Strategies, and Access to Care.
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DOI：
10.1080/23794925.2021.2013140
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发表时间：
2022
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对于患有注意力缺陷/多动障碍（ADHD）的青少年，他们的家人以及在学校系统中与他们一起工作的人来说，高中阶段是一个具有挑战性的发展时期。此外，在资源匮乏的城市环境中，种族少数化的家庭和学校往往会经历额外的不利经历，这可能会使获得循证精神卫生保健变得特别困难。这种定性调查的经验，黑人高中学生多动症，他们的照顾者，教师和学校的心理健康提供者（SMHPs）的目的是了解这个社区的经验与多动症的发展，并探讨障碍/促进充分的服务。通过与利益攸关方的焦点小组访谈（即，6名诊断为ADHD的青少年，5名ADHD青少年的照顾者，6名教师，5名学校心理健康提供者），出现的主题与（1）高中生ADHD表现中观察到的发展变化和（2）背景因素（包括最佳学校和家庭功能的障碍/促进因素）有关。这些主题导致了一个生态模型的发展，该模型显示了影响资源不足的城市公立高中中患有ADHD的黑人青少年经历的各种背景因素（例如，青少年的应对策略，照顾者参与，教师负担或缺乏ADHD知识，社会经济地位，获得护理）。这项定性研究代表了治疗开发项目的第一步，该项目评估了在城市公立学校环境中对患有ADHD的黑人青少年实施抑郁症预防干预的情况。临床意义（例如，讨论了如何协调家庭和学校之间的护理，更加关注健康的社会决定因素，确保在文化上有能力讨论多动症及其治疗）。
The high school years are a challenging developmental period for adolescents with attention-deficit/hyperactivity disorder (ADHD), their families, and those who work with them in the school system. Moreover, racially minoritized families and schools in low-resource, urban settings often experience additional adverse experiences that can make access to evidence-based mental health care particularly difficult. This qualitative investigation into the experiences of Black high school students with ADHD, their caregivers, teachers, and school mental health providers (SMHPs) aimed to understand this community’s experiences with ADHD across development and to explore the barriers/facilitators to adequate services. Through focus group interviews with stakeholders (i.e., 6 adolescents with a diagnosis of ADHD, 5 caregivers of adolescents with ADHD, 6 teachers, 5 school mental health providers), themes emerged related to (1) developmental changes observed in ADHD presentation in high school students and (2) contextual factors (including barriers/facilitators to optimal school and home functioning). These themes led to the development of an ecological model that show various contextual factors influencing the experiences of Black adolescents with ADHD in under-resourced urban public high schools (e.g., adolescents’ coping strategies, caregiver involvement, teacher burden or lack of ADHD-knowledge, socioeconomic status, access to care). This qualitative study represents the first step of a treatment development project assessing the implementation of a depression prevention intervention for Black adolescents with ADHD in urban public-school settings. Clinical implications (e.g., coordination of care between home and schools, increasing attention to social determinants of health, ensuring culturally competent discussion of ADHD and its treatment) are discussed.