Community Workshops on ADHD Improve Knowledge & Help Seeking Behaviour. Sharon Burey MD. FRCPC, Tecla Burey B.A. B. Ed.

Transcription

1 BACKGROUND AttentionDeficit/HyperactivityDisorder(ADHD)affectsbetween4 12%ofschoolaged children 1,8.Atanyonetimeapproximately380,000childreninCanadaarediagnosedwith ADHD 3,5.ThestigmaassociatedwithadiagnosisofADHDandlackofproperinformationabout ADHDresultsinunderdiagnosis,poorcompliancewithtreatmentandpooroutcomesfor childrenandfamilieswithadhd 2,4.Amultidisciplinarydiversecommunityteamwithashared visionwasestablishedin2006inwindsorontario.itwasspearheaded,inthiscase,bya pediatrician.theteamdevelopedcommunitybasedadhdawarenesscampaigntoraise awarenessaboutadhd. METHODS ConferenceswhereorganizedbythemembersoftheADHDAwarenessCommitteebetween SeptemberwasdesignatedADHDAwarenessmonthinWindsorandEssexCounty andeachseptemberavarietyofspeakers,andeventswereheld.thefullreportforeachyear s activitiesmaybefoundat InMarch2011aninternetsurveywassentto69oftheparticipantswhopreviouslyattended theworkshopsandwhohadsignedupwith addresses.therewere10surveyscompleted afterthesurveyrequestwassenttwice. TheresultsreportedherearethosefromaninternetsurveygiventoADHDAwarenessWindsor workshopattendeesinmarch2011abouttheirknowledge,attitude,help seekingbehaviour, andpatientservicedeliverypreference. RESULTS Therewasalowresponserateandthereforetheresultsofthesurveymaynotbeaccurate.The findingshoweverareintandemwiththegrowingbodyofevidencethatsupports psychoeducationandhealthliteracy,asmeansofimprovingknowledge,attitudesand behaviourwithregardtomentalhealth. 90%ofrespondersstronglyagreedoragreedthattheworkshopsimprovedtheirunderstanding ofadhd. 100%ofrespondersstronglyagreedoragreedthatthereisstigmaassociatedwithADHD. 87%ofrespondersagreedorstronglyagreedthattheyfeltmorecomfortableaccessingADHD servicesasaresultoftheworkshops. 90%ofrespondersstronglyagreedoragreedwithhavingADHDservicesdeliveredataschoolbasedmultidisciplinaryclinic,orviatheinternet;80%forphysician soffice;70%forcommunity healthclinicand60%formentalhealthagency. CADDRA Poster October 14 16, Page 1

2 Community Workshops on ADHD Improve Knowledge & Help Seeking Demographics:ParentsofchildrenoradolescentswithADHDcomprised40%ofattendees; peoplewhoidentifiedasapersonwithadhd14%;familymemberofachildoradolescent withadhd13%;teacher13%;others Paroleofficer(alsoagrandparent),andchildandyouth worker 20%.67%ofthepeoplewhoattendedtheworkshopwerefamilymembers,parentsof childrenwithadhdandpersonswithadhd. 78%ofpeoplewhorespondedwerebetween30 39yearsofage;22%between50 59;100% oftherespondentswerefemale Surveyresponders ParentofaChildwithADHD 20% PersonwithADHD 13% 40% FamilyMemberofaChildor AdolescentwithADHD Teacher 13% 14% Other(ParoleOfficer,Foster Parent,ChildandYouth Worker) CADDRA Poster October 14 16, Page 2

3 Community Workshops on ADHD Improve Knowledge & Help Seeking 0% Age 22% 78% Advertisingeffectiveness: Ofthepromotionalmediaused,Television,Newspaper,Radioappearedtobethemost effective,citedby35%ofrespondentsashowtheywereinformedabouttheworkshop:schools 23%;Physician soffices18%;flyer12%; 8%. Promo1onalMedia 13% 6% 31% Media(Radio,Television, Newspaper Physician'sOffice School 25% 6% Flyer 19% Other(FosterParent Associagon) CADDRA Poster October 14 16, Page 3

4 Weretheworkshopsinformative?100%ofrespondentsstronglyagreedoragreedthatthey wereinformative. Weretheworkshopsinforma1ve? 0% 80% 20% StronglyAgree Agree Disagree StronglyDisagree DidthetopicsdiscussedimproveyourunderstandingofADHD?90%ofrespondersstrongly agreedoragreedthattheworkshopsimprovedtheirunderstandingofadhd. Didthetopicsdiscussedimprove yourunderstandingofadhd? 0% 10% 70% 20% StronglyAgree Agree Disagree StronglyDisagree CADDRA Poster October 14 16, Page 4

5 DoyoufeelthatthereisstigmaassociatedwithADHD?100%ofrespondersstronglyagreedor agreedthatthereisstigmaassociatedwithadhd. Doyoufeelthatthereiss1gma associatedwithadhd? 0% 44% 56% StronglyAgree Agree Disagree StronglyDisagree DoyoufeelstigmatizedbecauseyouorafamilymemberhasADHD?70%ofrespondersagreed orstronglyagreedthattheyorafamilymemberwasstigmatizedbecausetheyhadadhd.this correlateswellwiththeresponderswhosewerefamilymembersofchildrenoradolescents withadhdorhadadhd. Doyoufeels1gma1zedbecauseyou orafamilymemberhasadhd? 20% 10% 40% 30% StronglyAgree Agree Disagree StronglyDisagree CADDRA Poster October 14 16, Page 5

6 AsaresultoftopicsdiscusseddoyoufeelmorecomfortableaccessingADHDservices?87%of respondersagreedorstronglyagreedthattheyfeltmorecomfortableaccessingadhdservices asaresultoftheworkshop. Asaresultoftopicsdicusseddoyou feelmorecomfortableaccessing ADHDservices? 0% 13% 87% StronglyAgree Agree Disagree StronglyDisagree Asaresultofthetopicsdiscussed,haveyouusedmorementalhealthservices?50%agreed while50%disagreedthattheyhaveusedmorementalhealthservicesasaresultofthe workshop. Asaresultoftopicsdiscussed,have youusedmorementalhealth services? 0% 50% 50% StronglyAgree Agree Disagree StronglyDisagree CADDRA Poster October 14 16, Page 6

7 Community Workshops on ADHD Improve Knowledge & Help Seeking Asaresultofthetopicsdiscussedhaveyouusedlessmentalhealthservices? 67%disagreedwhile33%agreedthattheyusedlessmentalhealthservicesasaresultofthe workshop. Asaresultoftopicsdiscussed,have youusedlessmentalhealthservices? 0% 67% 33% StronglyAgree Agree Disagree StronglyDisagree PleaseratethewayyoufeelaboutreceivingservicesforADHDinthefollowingways. Schoolbasedmultidisciplinaryclinic:90%ofrespondersagreedorstronglyagreedwiththis typeofservice. SchoolBasedMulitdisciplinaryClinic 0% 10% 60% 30% StronglyAgree Agree Disagree StronglyDisagree CADDRA Poster October 14 16, Page 7

8 Physicianoffice:80%ofrespondersagreedorstronglyagreedwiththistypeofservice. Physicianoffice 10% 10% 30% StronglyAgree Agree Disagree StronglyDisagree 50% Communityhealthclinic:70%agreedwiththistypeofservice. CommunityHealthClinic 0% 10% 20% 70% StronglyAgree Agree Disagree StronglyDisagree CADDRA Poster October 14 16, Page 8

9 Mentalhealthagency:60%agreedorstronglyagreedwiththisservice. Mentalhealthagency 10% 10% 30% 50% StronglyAgree Agree Disagree StronglyDisagree Internet:90%ofrespondersagreedorstronglyagreedwiththistypeofservice. 0% Internet 10% 10% StronglyAgree Agree Disagree StronglyDisagree 80% CADDRA Poster October 14 16, Page 9

10 Community Workshops on ADHD Improve Knowledge & Help Seeking Wouldyouattendanotherworkshop?100%agreedorstronglyagreedthattheywouldattend anotherworkshop. Responderswantedtohearsuchtopicsas, LatestbrainresearchonADHD TreatmentofADHDwithmedicine TreatmentofADHDwithlifestylechanges TreatmentofADHDwithcomplementarymedicine AcademicstrategiesforchildrenandadolescentswithADHD AccesstoADHDservicesinyourcommunity FoetalAlcoholSpectrum HowtomanageADHDinyourchildoradolescentwhenoneorbothparents haveadhdaswell DISCUSSION AttentionDeficit/HyperactivityDisorder(ADHD)affectsbetween4 12%ofschoolaged children 1,8.ThestigmaassociatedwithadiagnosisofADHDandlackofproperinformation aboutadhdresultsinunderdiagnosis,poorcompliancewithtreatmentandpooroutcomesfor childrenandfamilieswithadhd 2,4,8. UntreatedADHDmayleadtosubstanceabuse. UntreatedADHDmayleadtoschoolfailure,earlysexualactivity,andincreaseddriving accidents. MostchildrenandadultswithADHDhaveotherco associatedconditions,likelearning Disability,ODD,CD,AnxietyorDepression. Thereareeffectivepsychological,educational,andmedicaltreatmentsavailablefor ADHD. AccordingtoOfford 3,5,etal.,theprevalenceofADHDchildreninOntariois6.1%.The prevalenceofanymentalhealthdisorderis18.1%andonly16%reportserviceuseof specializedmentalhealthservices.over50%ifthesechildrenreceivedambulatorycare medicalserviceshowever.thehumanresourceneedstoprovidetheseservicesbychildand adolescentpsychiatristsandindeedtraditionalmentalhealthagenciesarewoefullyinadequate giventhepresentandprojectedpediatricpopulationinontario.pediatricians,familydoctors andotheralliedmentalhealthworkersneedtobetrainedandmarshaledtodeliverservices thatarepatientcenteredanddetermined.jenkins 6,4,reportedthat amultifacetedapproach involvingcommunity basedprogramsandservices,includingschools,shouldfocusonmental healthpromotionandprevention,whileprimarycarepractitionersshouldhandlemostbasic mentalhealthproblems,andspecialistsshouldfocusonsupportingprimarycareandproviding servicestothosewiththehighestneed. Indeedpatientswanttobemoreengaged,educated CADDRA Poster October 14 16, Page 10

11 Community Workshops on ADHD Improve Knowledge & Help Seeking andempoweredwithregardstotheirownhealth.theresponsestotheadhdawareness eventsinwindsor,ofover600attendeesspeaktothedesireoffamiliesandpatientswith ADHDtohavehealthinformationdeliveredinthismanner.Onsiteevaluationformsnotedthat theworkshopswereratedanaverageof3.5/4andaboveforspeakerrelevance,and informationreceived 7. Theresponseratetothesurveywaslow10respondersoutof69surveyssentout.The responderswereonlywomen,indicatingthetraditionofwomentobemoreengagedinthe healthoftheirfamilies.wehavetodomoretoengagemeninrespondingtosurveys.this maybeachievedatthepointofdeliveryofserviceandincentivized. Waddell 3 etal,notesthat, policymakersmustcometotermswiththehighnumbersof childreninvolvedincanada,giventhat1.1millionchildren(14%)haveclinicallyimportant mentaldisorders,ofwhichadhdisthemostprevalent.alsothat humanresourceand trainingissuesprecludereachingallchildreninneedofclinicalservices.amultifaceted approachwhichincludesinvestmentsinpopulationorpublichealthstrategies,inadditionto clinicalservicesisrequiredtotackletheburdenofhumansuffering 3. Communitybasedawarenesscampaignssuchasdescribedherecanbeveryeffectivein improvingknowledgeaboutadhd,reducingstigmaandimprovinghelpseekingbehaviour. AccordingtoFINIS(FrameworkIntegratingNormativeInfluencesonStigma), Itisthequality andnatureoftheinteractionthatmatters.onlyprogramswheresocialnetworktiesare sustained,meaningful,interactiveandpositivearelikelytohaveaninfluencethatisnot ephemeral 4.Mukolo,etal.,notethat Amongfamiliesofchildrenwithseriousemotional disorders,stigmahasbeendocumentedasapotentialbarriertoreceivingmentalhealth servicesprimarilybecauseoftheinfluenceofstigmaonparents 2.Furthermore, children rarelyseekprofessionalhelpontheirown;parentsorothercaregiversactastheiragentsand thusplayauniquerolethatmustbeacknowledgedandexamined 2,9 87%ofrespondersreportedthattheyfeltmorecomfortableaccessingADHDservicesasa resultoftheworkshop.90%ofrespondersfeltthattheirunderstandingofadhdimprovedasa resultofattendingtheworkshops.100%feltthatthereisstigmaassociatedwithadhd.asa resultoftheworkshops50%respondersusedmoreadhdservices. CONCLUSION CommunityworkshopscanimproveknowledgeandaffectADHDhelp seekingbehaviour. Responderspreferredoverwhelmingly(90%)toreceiveADHDhealthservicesinschool based clinicsorviatheinternet.inanerawherepatient centeredcareisnowthenewstandard,we havetomoveawayfromoldmodelsofcaredeliverytooneswhichhaveattheircenterthe patientandfamily.attheveryleastnewfundingmodelsandpartnershipsforphysiciansand otherhealthprovidersneedtobesupported,sothatchildrencanreceivemoreschool based ADHDhealth relatedservicesandservicesinprimarycaresettings.localcommunityawareness workshopsleadbylocalphysiciansorhealthcarepartnerswhoareabletosustainsocial networktiesmaybeveryimportantinreducingstigma,improvingknowledgeandhelp seeking behaviorsofadhdfamilies. CADDRA Poster October 14 16, Page 11

12 Implications Furtherfundingofcommunityawarenessworkshopsandresearchintotheir effectivenessinreducingstigma,improvingknowledgeandhelpseekingbehaviouraswellas healthoutcomesiswarranted. References 1.Faraone,SV.etal.TheworldwideprevalenceofADHD.WorldPsychiatry2003June,2(2): Mukolo,A.etal.TheStigmaofChildhoodMentalDisorders:Aconceptualframework.Journal ofamericanacademyofchild&adolescentpsychiatry.feb.2010;49(2): Waddell,C.Offord,D.etal.ChildpsychiatryepidemiologyandCanadianpublicpolicymaking:TheStateoftheScienceandtheartofthepossible.CanJPsychiatry,Nov2002; 47(9): Pescosolido,B.Martin.J.,etal.Rethinkingtheoreticalapproachestostigma:Aframework IntegratingNormativeInfluencesonStigma(FINIS).SocialScience&Medicine67(2008) OffordDR.BoyleMH.etal., OntarioChildHealthStudy.II.Six monthprevalenceofdisorder andratesofserviceutilization.archgenpsychiatry 1987;44(9): JenkinsR.Makingpsychiatricepidemiologyuseful:thecontributionofepidemiologyto governmentpolicy.actapsychiatrscand2001;103: ADHDAwarenessWindsor.Reportofworkshop ; 8.InternationalConsensusStatementonADHD:January 2002 ClinicalChildandFamilyPsychologyReview(June2002),5(2),pg BrannanAM,etal.Caregiver,child,familyandservicesystemcontributetocaregiverstrain intwochildmentalhealthservicesystems.jbehavhealthserviceres.2006;33: CADDRA Poster October 14 16, Page 12