A role for community health workers in pediatric ADHD treatment through the delivery of behavioral parent training
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INTRODUCTION: Community health workers are a growing and developing portion of the healthcare workforce. They have proven successes in decreasing healthcare inequities for many common chronic medical conditions, such as asthma, and have secured support at the Department of Health and Human Services. One common medical condition for which community health workers have not yet been explored as a resource is pediatric Attention Deficit Hyperactivity Disorder. We sought to investigate what the literature showed on community health workers' involvement in ADHD treatments thus far, and to specifically investigate which ADHD behavioral parent training program could best be adapted to a pilot study where community health workers were the intervention delivery agents. METHODS: We performed a systematic review of the literature on evidence based behavioral parent training programs for children with ADHD. Parent training interventions were compared for ease of application to a community health worker home-visit model. Program ability to successfully reduce child behavior problems and improve parenting practices was analyzed. RESULTS: 8 full text articles were analyzed in depth and grouped by intervention type. 1 article was a sports-based intervention for fathers, 1 was meant to improve attendance rates, 1 was a combined child-targeted and parent-targeted Behavioral Parent Training (BPT) therapy, 2 were based on the "New Forest Parenting Package", and 3 were based on Barkley's 1997 manualized BPT. DISCUSSION: Evidence exists for the ability of community health workers to deliver a behavioral therapy to families of children with ADHD, specifically behavioral parent training. Barkley's manualized BPT had the best combination in our study of positive outcomes for families and ease of adaptability to in-home delivery. We recommend a pilot study be conducted using a modified version of Barkley's BPT and have community health workers as the delivery agents to begin to see what role community health workers can play in the treatment of pediatric ADHD.
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