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

Abstract

Objective: 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. Methods: 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. Results: 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. Conclusion: 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. Practice implications: 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.