The impact of social determinants of health and trajectories of medication use on functional outcomes in children with ADHD: study protocol.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder characterised by inattention, hyperactivity and impulsivity, resulting in impaired functioning in multiple settings, including home, school and in social settings. Disparities exist in ADHD care among children, with White male children experiencing increased access to diagnosis and treatment. Other children remain underdiagnosed, undertreated and subject to poorer functional outcomes. Factors that impact equitable ADHD treatment include gender, race, ethnicity and social determinants of health (SDOH), including household income, parental education, insurance status, neighbourhood deprivation and discrimination. Medication is effective, yet little is known regarding the impact of medication type and trajectories of use on functional outcomes.

AIMS: Data from the first 6 time points of the Adolescent Brain and Cognitive Development℠ Study® (N = 11 868) will be used to address the following aims. Aim 1: identify typologies of children with distinct trajectories of medication use using multivariate latent class growth analysis. Aim 2: identify typologies of children with distinct trajectories of child-reported functional outcomes using latent class growth analysis. Aim 3: examine relationships of gender, race, ethnicity, SDOH and medication use with trajectories of functional outcomes using multinomial logistic regression.

METHOD: This study protocol describes the background and methods for an observational study seeking to better understand the impact of gender, race, ethnicity, SDOH and trajectories of medication use on child-reported functional outcome trajectories in a diverse group of US children with ADHD.

CONCLUSIONS: Findings will advance the understanding of effective ADHD treatment and highlight the importance of equitable treatment access.