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Parents' Preferences for School- and Community-Based Services for Children at Risk for ADHD

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Abstract

This study used conjoint analysis, trade-off methodology employed by marketing researchers and health economists, to examine preferences of parents for school- and community-based interventions for childhood ADHD. Participants were 29 mothers (86.2% Caucasian) of boys aged 5–13 years with or at risk of ADHD. Mothers completed a conjoint survey that examined trade-offs across 15 attributes of service content (e.g., materials, resources), process (e.g., time demand, format/delivery mode), and outcome (e.g., improvement in children's behavioral functioning). Findings suggest that parents preferred services maximizing children's behavioral and social outcomes (relative to family functioning). Parents were willing to give up services with desirable delivery features (such as daily homeschool notes and child's frequent participation in therapy) for programs optimizing outcomes. Simulation analyses, forecasting tools that predict how respondents would behave in the real world, revealed that 62.1% of parents were predicted to prefer a standard, evidence-informed school-based service involving daily teacher involvement and monthly parent involvement, while 37.9% of parents were predicted to use a standard, evidence-informed community-based service involving daily parent involvement and monthly teacher involvement. Findings from this study show that parents value improved social and behavioral outcomes more than desirable service delivery features. However, results suggest that if the treatment package includes school-based services in which there is greater teacher involvement and less parent involvement, a majority of parents prefer school services, especially if they involve children's ongoing use of self-control strategies. Results suggest ways in which the delivery of effective treatments needs to be altered to make them more palatable and acceptable by parents. Other implications for school-based practitioners are discussed.

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Notes

  1. Although the term “intervention” may more commonly used by school mental health professionals, it is our impression that “therapy” is more commonly used among parents. As such, we refer to “intervention” in the text of this manuscript to appeal to the readership of this journal. However, we asked parents in the survey about their preferences for their child's “therapy.”

  2. We use the term “prefer” instead of “predicted to prefer,” language used by marketing researchers (Orme, 2013), here and throughout the manuscript to enhance readability of the text.

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Acknowledgements

The author would like to extend gratitude to the parents who participated in the project, the graduate students who coded information from focus groups, and the research assistants and camp staff who helped administer the survey. The author would also like to thank the consultants at Sawtooth Software for their input on statistical analysis. The author would also like to thank Steven W. Evans, Julie Owens, Brian Wymbs, and Theresa Egan for providing feedback on the manuscript.

Funding

This study was funded by the Ohio University Research Committee.

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  1. Department of Family Medicine, Ohio University, Athens, USA

    Frances A. Wymbs

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Correspondence to Frances A. Wymbs.

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Informed consent was obtained from all individual participants included in the study.

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Wymbs, F.A. Parents' Preferences for School- and Community-Based Services for Children at Risk for ADHD. School Mental Health 10, 386–401 (2018). https://doi.org/10.1007/s12310-018-9258-3

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