Parental Health Literacy and Child ADHD

父母健康素养和儿童多动症

• 批准号: 7694264
• 负责人: Lynn Kari Hironaka
• 金额: $ 8.34万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7694264
• 关键词: Adult; Affect; Appointment; Attention deficit hyperactivity disorder; Behavior Therapy; Boston; Cessation of life; Child; Childhood; Chronic; Chronic Disease; Cohort Studies; Collection; Communication; Complex; Confusion; Data; Diabetes Mellitus; Diagnosis; Disease; Disease Management; Effectiveness; Evidence based treatment; Family; Feasibility Studies; Future; Health; Health care facility; Healthcare Systems; Holidays; Hospitalization; Hospitals; Individual; Information Services; Institute of Medicine (U.S.); Intervention; Knowledge; Low income; Measures; Medical center; Morbidity - disease rate; Outcome; Outcome Measure; Parents; Pharmaceutical Preparations; Population; Prevalence; Preventive; Preventive Health Services; Process; Recruitment Activity; Reporting; Research; Risk; Risk Factors; School-Age Population; Schools; Self Management; Services; Source; Symptoms; Techniques; Testing; Time; Treatment Protocols; Urban Population; cohort; design; evidence base; follow-up; glycemic control; health literacy; improved; medical appointment; prospective; public health relevance; safety net; skills; socioeconomics; teacher

DESCRIPTION (provided by applicant): Health literacy is defined by the Institute of Medicine in its 2004 report entitled, Health Literacy - A Prescription to End Confusion, as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (2)." Limited health literacy has been associated with a range of adverse adult health outcomes including increased risk of hospitalization, decreased utilization of preventive health services, adverse disease-specific outcomes, and death (3-6). Few studies, however, have examined the relationship between parental health literacy skills and chronic childhood illnesses. One childhood illness in which health literacy is potentially important is Attention Deficit Hyperactivity Disorder (ADHD). ADHD is one of the most common chronic diseases of childhood, affecting 5-10 percent of school-aged children in the US (34-37). Multiple studies have shown the efficacy of medication therapy in the treatment of ADHD (44, 45); however, the data also demonstrate that only half of all children with ADHD utilize evidence- based medication regimens (34). The effective management of ADHD is complex, often requiring daily medications, the utilization of behavioral modification techniques, and close communication between parents, schools, and health care facilities. Given the complexities of ADHD management, we hypothesize that limited parental health literacy is likely to negatively impact the outcomes of children with ADHD. We propose to study the feasibility of a 6-month prospective cohort study to be conducted at Boston Medical Center, an urban safety-net hospital. We believe that a feasibility study, in which we will follow 40 parent/child dyads for 6-months, will allow us to develop the capacity to recruit and maintain an appropriately powered study in the future. This is particularly important in our population for whom the risk of poor follow-up may be increased by socioeconomic risk factors and parental ADHD. The aims of our study will be to: 1) Field test the logistical aspects of the study; 2) Obtain empirical estimates of study parameters that will inform the planning of an appropriately powered prospective cohort study; and 3) Obtain estimates of the associations between parental health literacy and the following measures: a) use of pharmacologic therapy for the treatment of child ADHD, b) parental ADHD-specific health knowledge, c) number of both attended and missed medical appointments for ADHD management, and d) change in child ADHD symptoms over time. If limited parental health literacy is found to be associated with poor child ADHD outcomes, we plan to develop specific interventions to increase the use of effective ADHD therapies for children of parents with limited health literacy skills. PUBLIC HEALTH RELEVANCE: ADHD is a common childhood illness associated with considerable morbidity, yet many families fail to utilize evidence-based treatments. It is the potential mutability of health literacy and the capacity of the health care system to accommodate specific needs which makes it such a desirable risk factor to consider. If limited health literacy is found to be associated with poor child ADHD outcomes, we plan to develop interventions to increase the utilization of effective ADHD therapies in children of parents with limited health literacy skills.

描述（由申请人提供）：医学研究所在其 2004 年题为“健康素养 - 结束混乱的处方”的报告中将健康素养定义为“个人有能力获取、处理和理解做出适当健康决策所需​​的基本健康信息和服务的程度 (2)”。健康素养有限与一系列不良的成人健康结果相关，包括住院风险增加、预防性卫生服务利用率降低、特定疾病的不良结果和死亡 (3-6)。然而，很少有研究探讨父母健康素养技能与慢性儿童疾病之间的关系。注意力缺陷多动障碍 (ADHD) 是一种健康素养可能很重要的儿童疾病。 ADHD 是儿童最常见的慢性疾病之一，影响美国 5-10% 的学龄儿童（34-37 岁）。多项研究表明药物治疗对治疗 ADHD 具有疗效 (44, 45)；然而，数据还表明，只有一半的多动症儿童采用循证药物治疗方案 (34)。 ADHD 的有效管理很复杂，通常需要日常药物治疗、使用行为矫正技术以及家长、学校和医疗机构之间的密切沟通。鉴于多动症管理的复杂性，我们假设父母的健康素养有限可能会对多动症儿童的治疗结果产生负面影响。我们建议研究在波士顿医疗中心（一家城市安全网医院）进行为期 6 个月的前瞻性队列研究的可行性。我们相信，一项为期 6 个月跟踪 40 名家长/儿童的可行性研究将使我们能够培养未来招募和维持适当动力研究的能力。这对于我们的人群来说尤其重要，对他们来说，社会经济风险因素和父母多动症可能会增加随访不良的风险。我们研究的目的是： 1) 现场测试研究的后勤方面； 2) 获得研究参数的经验估计，为适当动力的前瞻性队列研究的规划提供信息； 3) 估计父母健康素养与以下措施之间的关联：a) 使用药物疗法治疗儿童 ADHD，b) 父母 ADHD 特定健康知识，c) 就诊和错过 ADHD 管理医疗预约的数量，以及 d) 儿童 ADHD 症状随时间的变化。如果发现父母的健康素养有限与儿童多动症的不良结局有关，我们计划制定具体的干预措施，以增加对健康素养技能有限的父母的孩子使用有效的多动症疗法的使用。公共卫生相关性：多动症是一种常见的儿童疾病，发病率相当高，但许多家庭未能采用循证治疗。健康素养的潜在可变性和医疗保健系统满足特定需求的能力使其成为值得考虑的风险因素。如果发现健康素养有限与儿童多动症结局不佳有关，我们计划制定干预措施，以提高健康素养技能有限的父母的儿童对有效多动症疗法的利用。