Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes
ABSTRACT Objectives To determine whether an intensive multi-modal ADHD intervention for children and teens resulted in improved long-term health and educational outcomes and in reduced inequity in these outcomes across the socioeconomic gradient. Approach We used administrative data from the hea...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Swansea University
2017-04-01
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| Series: | International Journal of Population Data Science |
| Online Access: | https://ijpds.org/article/view/24 |
| _version_ | 1797426546695208960 |
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| author | Mark Smith Dan Chateau Jennifer Enns Jason Randall James Bolton Laurence Katz Elaine Burland Alan Katz Marni Brownell Collette Raymond |
| author_facet | Mark Smith Dan Chateau Jennifer Enns Jason Randall James Bolton Laurence Katz Elaine Burland Alan Katz Marni Brownell Collette Raymond |
| author_sort | Mark Smith |
| collection | DOAJ |
| description | ABSTRACT
Objectives
To determine whether an intensive multi-modal ADHD intervention for children and teens resulted in improved long-term health and educational outcomes and in reduced inequity in these outcomes across the socioeconomic gradient.
Approach
We used administrative data from the healthcare and education sectors in the Population Health Data Repository at the Manitoba Centre for Health Policy. We identified children and teens aged 5-17 who had 3+ visits to the ADHD intervention program between 2007 and 2012. A matched control group was constructed, and confounders were controlled using inverse probability of treatment weights. We examined rates of hospital episodes, emergency department visits, psychostimulant use and adherence, contact with child and family services, and whether the children were in the school grade appropriate to their age. We calculated concentration indices to measure changes in inequity.
Results
There were 485 children in the ADHD intervention group and 1,884 controls. Children who received the intervention were more likely to be prescribed medication (patients with 1+ prescription(s), rate ratio [RR] 1.21, 95% CI 1.08-1.36) and be adherent to their medication (RR 1.42, 95% CI 1.03-1.96). They were also more likely to be in their age-appropriate grade (RR 1.33, 95% CI 1.09-1.63) compared to controls. Moreover, the intervention was associated with reduced inequity in these outcomes across income deciles. No difference in the rates of hospital episodes or emergency department visits was found, nor in rates of contact with child and family services.
Conclusions
A multi-modal ADHD intervention program was associated with increased use and adherence to medication, and may boost academic achievement for vulnerable children and teens. It contributed to closing the equity gap between children from low- and high-income families. ADHD interventions that combine approaches may be more effective than medication alone. |
| first_indexed | 2024-03-09T08:31:48Z |
| format | Article |
| id | doaj.art-6fed5387ae8940b2b1c04c90eca95ad6 |
| institution | Directory Open Access Journal |
| issn | 2399-4908 |
| language | English |
| last_indexed | 2024-03-09T08:31:48Z |
| publishDate | 2017-04-01 |
| publisher | Swansea University |
| record_format | Article |
| series | International Journal of Population Data Science |
| spelling | doaj.art-6fed5387ae8940b2b1c04c90eca95ad62023-12-02T19:46:19ZengSwansea UniversityInternational Journal of Population Data Science2399-49082017-04-011110.23889/ijpds.v1i1.2424Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational OutcomesMark Smith0Dan Chateau1Jennifer Enns2Jason Randall3James Bolton4Laurence Katz5Elaine Burland6Alan Katz7Marni Brownell8Collette Raymond9Manitoba Centre for Health PolicyManitoba Centre for Health PolicyManitoba Centre for Health PolicyManitoba Centre for Health PolicyUniversity of ManitobaUniversity of ManitobaManitoba Centre for Health PolicyManitoba Centre for Health PolicyManitoba Centre for Health PolicyManitoba Centre for Health PolicyABSTRACT Objectives To determine whether an intensive multi-modal ADHD intervention for children and teens resulted in improved long-term health and educational outcomes and in reduced inequity in these outcomes across the socioeconomic gradient. Approach We used administrative data from the healthcare and education sectors in the Population Health Data Repository at the Manitoba Centre for Health Policy. We identified children and teens aged 5-17 who had 3+ visits to the ADHD intervention program between 2007 and 2012. A matched control group was constructed, and confounders were controlled using inverse probability of treatment weights. We examined rates of hospital episodes, emergency department visits, psychostimulant use and adherence, contact with child and family services, and whether the children were in the school grade appropriate to their age. We calculated concentration indices to measure changes in inequity. Results There were 485 children in the ADHD intervention group and 1,884 controls. Children who received the intervention were more likely to be prescribed medication (patients with 1+ prescription(s), rate ratio [RR] 1.21, 95% CI 1.08-1.36) and be adherent to their medication (RR 1.42, 95% CI 1.03-1.96). They were also more likely to be in their age-appropriate grade (RR 1.33, 95% CI 1.09-1.63) compared to controls. Moreover, the intervention was associated with reduced inequity in these outcomes across income deciles. No difference in the rates of hospital episodes or emergency department visits was found, nor in rates of contact with child and family services. Conclusions A multi-modal ADHD intervention program was associated with increased use and adherence to medication, and may boost academic achievement for vulnerable children and teens. It contributed to closing the equity gap between children from low- and high-income families. ADHD interventions that combine approaches may be more effective than medication alone.https://ijpds.org/article/view/24 |
| spellingShingle | Mark Smith Dan Chateau Jennifer Enns Jason Randall James Bolton Laurence Katz Elaine Burland Alan Katz Marni Brownell Collette Raymond Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes International Journal of Population Data Science |
| title | Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes |
| title_full | Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes |
| title_fullStr | Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes |
| title_full_unstemmed | Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes |
| title_short | Effect of an Intensive Multi-Modal Intervention for Attention-Deficit Hyperactivity Disorder (ADHD) on Equity in Children’s Health and Educational Outcomes |
| title_sort | effect of an intensive multi modal intervention for attention deficit hyperactivity disorder adhd on equity in children s health and educational outcomes |
| url | https://ijpds.org/article/view/24 |
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