Provider use of a participatory decision-making style with youth with ADHD and their caregivers and visit satisfaction.

Abstract

To examine whether youth with ADHD who received a question prompt list and video intervention and their caregivers were more likely to: (a) be asked about their treatment preferences, (b) have their input included into treatment decisions, (c) rate their providers as using more of a participatory decision-making (PDM) style, and (d) be more satisfied with their visits. Youth with ADHD were randomized to a pre-visit question prompt list intervention or usual care. Visits were audio-recorded; youth were interviewed after visits; caregivers completed questionnaires. Multivariable linear regression was used to analyze the data. 102 youth with ADHD and their caregivers participated. Providers included youth and caregiver input into ADHD management decisions during 12 % and 20 % of audio-taped visits, respectively. Youth and caregivers of youth who were in the intervention group were significantly more likely to rate providers as using more of a participatory decision-making style. Black youth and caregivers were significantly less likely to rate their providers as using a participatory style than non-Black youth. Youth and caregiver ratings of provider use of a participatory style were significantly associated with greater visit satisfaction. Both youth and caregivers rated providers high on using a participatory decision-making style. Yet providers could include youth and caregiver input more into ADHD management decisions. Black youth and caregivers rated providers lower on using a participatory decision-making style than non-Black youth and caregivers. Youth and caregivers were more satisfied with visits where they rated their providers as using a more participatory style. Providers should include both youth and caregiver input into ADHD management decisions. Providers should attempt to use a more participatory decision-making style with Black youth and caregivers.