Patient-Centered Medical Homes and Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs and Adherence

Patient-Centered Medical Homes and Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs and Adherence by Sydney L. Watkins MS, Howard University, 1989 BS, Howard University, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University February 2018 Abstract As many as 87% of children discontinue ADHD medication, which can lead to clinically significant academic, cognitive, and social impairment. ADHD costs billions of dollars to the healthcare and educational systems, and previous attempts to stem these costs and increase ADHD medication adherence have been unsuccessful. The purpose of this study was to determine if patient-centered medical homes (PCMH), which have been shown to improve patient health outcomes, impact parental beliefs (benefits vs. risks) about ADHD medication and adherence to ADHD medication. The theory of planned behavior was the theoretical framework for this study. There were 294 parents of children between the ages of 5 and 12 who had been prescribed ADHD medication who participated in a quantitative self-administered survey. Parental beliefs were assessed using the Beliefs About Medicines Questionnaire–Specific, and medication adherence was assessed using the Morisky Medication Adherence Scale–8. The 2007 National Survey of Children’s Health was used to determine group assignment. A MANCOVA was used to analyze the data and found parents in the PCMH group scored significantly higher in their beliefs that the benefits outweighed the risks of ADHD medication. However, no significant differences were found between groups related to parental adherence to ADHD medication. More research is recommended to learn how PCMHs can change positive ADHD medication beliefs into better ADHD medication adherence. This study has social change implications as it increases what is known about PCMHs and how they impact health outcomes. It also supports previous literature in the need to deliver all PCMH services, which is required to realize the full benefit of PCMHs.As many as 87% of children discontinue ADHD medication, which can lead to clinically significant academic, cognitive, and social impairment. ADHD costs billions of dollars to the healthcare and educational systems, and previous attempts to stem these costs and increase ADHD medication adherence have been unsuccessful. The purpose of this study was to determine if patient-centered medical homes (PCMH), which have been shown to improve patient health outcomes, impact parental beliefs (benefits vs. risks) about ADHD medication and adherence to ADHD medication. The theory of planned behavior was the theoretical framework for this study. There were 294 parents of children between the ages of 5 and 12 who had been prescribed ADHD medication who participated in a quantitative self-administered survey. Parental beliefs were assessed using the Beliefs About Medicines Questionnaire–Specific, and medication adherence was assessed using the Morisky Medication Adherence Scale–8. The 2007 National Survey of Children’s Health was used to determine group assignment. A MANCOVA was used to analyze the data and found parents in the PCMH group scored significantly higher in their beliefs that the benefits outweighed the risks of ADHD medication. However, no significant differences were found between groups related to parental adherence to ADHD medication. More research is recommended to learn how PCMHs can change positive ADHD medication beliefs into better ADHD medication adherence. This study has social change implications as it increases what is known about PCMHs and how they impact health outcomes. It also supports previous literature in the need to deliver all PCMH services, which is required to realize the full benefit of PCMHs. Patient-Centered Medical Homes and Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs and Adherence by Sydney L. Watkins MS, Howard University, 1989 BS, Howard University, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University February 2018 Dedication This research is dedicated to my parents, Joan and Robert Watkins, who instilled in me the value of education and always encouraged and supported me to do my best. Mom and Dad in heaven, for all of your sacrifices that allowed me to have the things that you did not, for all of the times that you cheered me on to support my dreams, and for all of the love that you poured into me, I thank you and love you more than I could ever express! I did it Dad! I hope you are proud! Acknowledgments I want to thank my committee, Dr. Rex Philpot, Dr. Elisha Galaif, and particularly my chair Dr. Anthony Perry, for all of your support through my dissertation journey. I also want to thank my friends, family, and Alpha Kappa Alpha sorors who encouraged me along the way.