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“If he doesn’t buy in, it’s a waste of time”: Perspectives from diverse parents and adolescents on engaging children in ADHD treatment


Engaging children and adolescents in ADHD care is critical for future independent disease management. However, there is a lack of evidence guiding health professionals and parents on how best to engage their children and adolescents in ADHD care. We recruited 41 diverse parents of children and adolescents with ADHD and 11 adolescents with ADHD from an urban, safety-net hospital to participate in in-depth, semi-structured qualitative interviews and then analyzed this data using thematic analysis. Children’s level of illness insight about ADHD and self-esteem emerged as two major contributors to engagement of children and adolescents in ADHD care, and their intersection created four styles of engagement: proactive (high insight, high self-esteem), anxious (high insight, low self-esteem), apathetic (low insight, high self-esteem), and resistant (low insight, low self-esteem). This framework can help health professionals engage children and adolescents in care for ADHD and guide development of interventions to improve engagement in care.

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No honorarium, grant, or other forms of payment were given to anyone to produce this manuscript. The sponsors who provided the funding necessary to complete this research, the Gordon and Betty Moore Foundation (Grant #: 5300) and the National Institute of Mental Health (Grant #: K23 MH118478), had no involvement in study design, data collection, data analysis or interpretation, preparation of, or decision to submit this manuscript.

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Authors and Affiliations



A.S., J.S., and K.L. obtained funding and outlined the protocols for this project. A.S., N.Z., J.S., K.L., S.H., K.R., O.B., and M.R. participated in the recruitment of subjects and collection of data. A.S., N.Z., J.S., and K.L., in collaboration with the research team, conducted the qualitative analysis. N.Z. wrote the main manuscript text and prepared the figure. T.B. ensured a rigorous analytic process using her expertise in research methods; ran all quantitative analyses for the project; and prepared the tables. A.D., L.F., C.B., and M.S. all periodically reviewed and provided their expertise throughout the process of crafting this report. All authors reviewed the manuscript.

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Correspondence to Andrea E. Spencer.

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Zolli, N., Loubeau, J.K., Sikov, J. et al. “If he doesn’t buy in, it’s a waste of time”: Perspectives from diverse parents and adolescents on engaging children in ADHD treatment. Child Psychiatry Hum Dev (2022).

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  • ADHD
  • Engagement in care
  • Qualitative research
  • Self-esteem
  • Illness insight