Graduation Date

Spring 5-10-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Promotion and Disease Prevention Research

First Advisor

Melissa Tibbits, PhD

Second Advisor

Cynthia Ellis, MD

Third Advisor

Shinobu Watanabe-Galloway, PhD

Fourth Advisor

Christopher Wichman, PhD

MeSH Headings

Attention-Deficit/Hyperactivity Disorder; Medical Home; Family-Centered Care; Care Coordination

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder impacting up to 10% of U.S. youth, and is associated with several negative social, health, and academic or occupational outcomes. Risk and prognostic factors for ADHD are multifactorial, and the management of youth ADHD is multimodal. Familial environments are one prognostic factor for ADHD, with family resilience being positively associated with youth ADHD prognosis. Researchers exploring multilevel interventions for the management of youth ADHD have proposed health care systems as a setting for interventions targeting family resilience, however little research examines the relationship between health care system factors and family factors in families of children and adolescents with ADHD. The studies in this dissertation examine the relationship between three health care system factors, including family-centered care, care coordination, and parental emotional support from a health care provider, and family resilience, using the Family Resilience and Connection Index (FRCI) as an outcome measure. Outcomes demonstrate a statistically significant relationship between family-centered care and FRCI, as well as care coordination and FRCI. There was not a statistically significant relationship between parental emotional support from a health care provider and FRCI. As models of care for youth with ADHD, such as the Medical Home Model, include multiple health care system factors, future research should examine the comparative and/or cumulative impacts these health care system factors have on family resilience to better inform health care system practices in the management of children and adolescents with ADHD.

Comments

2025 Copyright, the authors

Available for download on Wednesday, August 27, 2025

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