William B. Brinkman|Jessica Hartl|Lauren M. Rawe|Heidi Sucharew|Maria T. Britto|Jeffery N. Epstein
Physicians' Shared Decision-Making Behaviors in Attention-Deficit/Hyperactivity Disorder Care
University of Cincinnati Medical Center|Center for Innovation
describe amount shared decisionmaking sdm behavior exhibited treatmentplanning encounters children newly diagnosed attentiondeficithyperactivity disorder explore relationships participant characteristics amount sdmprospective cohort studyseven communitybased primary care pediatric practices cincinnati ohio northern kentucky southeast indiana regions october 5 2009 august 9 2010ten pediatricians 26 families 6 10yearold child newly diagnosed attentiondeficithyperactivity disorderthe amount sdm behavior exhibited videorecorded encounters coded 2 independent raters using validated observing patient involvement option scale adapted use pediatric settings produces score ranging 0 parental involvement 100 maximal parental involvementtreatment decisions focused initiation medication treatment mean sd total option score 285 117 sdm observed encounters involving families white vs nonwhite children adjusted mean difference score 149 95 confidence interval ci 102196 p 001 private vs public health insurance coverage adjusted mean difference score 151 112190 p 001 mothers least college education vs high school graduate less adjusted mean difference score 123 72174 p 001 parents screen positive serious mental illness vs adjusted mean difference score 150 119181 p 001low levels sdm observed exploratory analyses identified potential disparities barriers interventions may needed foster sdm parents especially nonwhite race lower socioeconomic status lower educational level serious mental illness