Neuropsychiatric disease and treatment · 2026
Determinants of ADHD Health Literacy and Public Awareness of Child-Friendly City Policies in Wenzhou: A Cross-Sectional Survey.
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Ye Jingwei, Wen Yuan, Zhang Tianyun, Zeng Yihao, Jin Xiaxin, Lin Jingyan, Du Shenghui, Yang Xiaolan, Zhan Jingyang, Hla Khaing Wut Yi, Shu Xianghan, Wang Dan
Аннотация
OBJECTIVE: To evaluate adult Attention Deficit Hyperactivity Disorder (ADHD)-related health literacy, its determinants, and public awareness of local Child-Friendly City (CFC) policies in Wenzhou.
METHODS: This study adopted a mixed-methods design. The quantitative cross-sectional survey recruited 1792 adults (≥18 years), applying a validated 9-item ADHD knowledge scale to gauge ADHD health literacy. Independent t-tests, one-way Analysis of Variance (ANOVA) and chi-square tests, factorial ANOVA, and Poisson regression respectively analyzed univariate group disparities, multivariate interactions, and independent predictors of literacy outcomes. For the qualitative strand, independent semi-structured interviews with 300 participants (including minors) were conducted to explore public perceptions and awareness of local CFC policies. Thematic analysis was adopted to synthesize interview narratives about policy understanding and dissemination.
RESULTS: Single-factor analysis initially revealed potential associations between educational level, occupation, attitudes toward ADHD, and having relatives or friends with ADHD were significant influencing factors in both regions (all P<0.05), with significant interactions (eg interaction of parental status, age, and educational level; all P<0.05). Yet these associations reversed after adjustment for confounders. Poisson regression, confirmed educational level (β = 0.0624), positive attitude (β = 0.0758) and do not know having relatives or friends with ADHD (β = 0.1002) as positive predictors (β = 0.1002) (all P<0.05). Regarding policy awareness, Dongtou District showed superior understanding overall compared to the Wenzhou Urban Area (all P<0.05), and professional groups (healthcare- and education-related practitioners) exhibited significantly higher awareness levels than the general public.
CONCLUSIONS: Wenzhou adults have moderately low ADHD health literacy with regional and social disparities. Higher educational level, positive attitude, and do not know having relatives or friends with ADHD predicted superior literacy, while female gender, urban residence, and professional identities correlate with lower levels. CFC policy awareness is inadequate. Targeted dissemination for high-priority groups and region-adapted support systems are needed.
METHODS: This study adopted a mixed-methods design. The quantitative cross-sectional survey recruited 1792 adults (≥18 years), applying a validated 9-item ADHD knowledge scale to gauge ADHD health literacy. Independent t-tests, one-way Analysis of Variance (ANOVA) and chi-square tests, factorial ANOVA, and Poisson regression respectively analyzed univariate group disparities, multivariate interactions, and independent predictors of literacy outcomes. For the qualitative strand, independent semi-structured interviews with 300 participants (including minors) were conducted to explore public perceptions and awareness of local CFC policies. Thematic analysis was adopted to synthesize interview narratives about policy understanding and dissemination.
RESULTS: Single-factor analysis initially revealed potential associations between educational level, occupation, attitudes toward ADHD, and having relatives or friends with ADHD were significant influencing factors in both regions (all P<0.05), with significant interactions (eg interaction of parental status, age, and educational level; all P<0.05). Yet these associations reversed after adjustment for confounders. Poisson regression, confirmed educational level (β = 0.0624), positive attitude (β = 0.0758) and do not know having relatives or friends with ADHD (β = 0.1002) as positive predictors (β = 0.1002) (all P<0.05). Regarding policy awareness, Dongtou District showed superior understanding overall compared to the Wenzhou Urban Area (all P<0.05), and professional groups (healthcare- and education-related practitioners) exhibited significantly higher awareness levels than the general public.
CONCLUSIONS: Wenzhou adults have moderately low ADHD health literacy with regional and social disparities. Higher educational level, positive attitude, and do not know having relatives or friends with ADHD predicted superior literacy, while female gender, urban residence, and professional identities correlate with lower levels. CFC policy awareness is inadequate. Targeted dissemination for high-priority groups and region-adapted support systems are needed.