Getting to First Base: Promoting Engagement in Family–School Intervention for Children with ADHD in Urban, Primary Care Practice

The optimal model of intervention for children with ADHD is typically a multimodal approach involving a partnership across the family, school, and primary care health systems. Unfortunately, even when multimodal interventions are available, mental health services generally are underutilized, particularly by children and families of racial and ethnic minority background who often reside in under-resourced, urban settings. Partnering to Achieve School Success (PASS) was developed as a service based in urban primary care settings to foster partnerships among the family, school, and primary care practice and promote engagement in intervention. This study was designed to examine the pre-treatment telephone history of contacts between clinicians and families to determine early indicators of engagement and potential strategies to improve treatment initiation. The data were derived from a retrospective analysis of 80 cases referred by primary care providers to PASS. Findings indicated that success rates of clinician-initiated contact and number of parent-initiated attempts were independent predictors of treatment initiation. Also number of minutes of actual phone contact predicted treatment initiation. Follow-up analyses suggested that amount of phone contact may serve as a mediator in the relationship between phone contact (clinician-initiated and parent-initiated) and treatment initiation. The predictive value of telephone contact was affirmed, and strategies for using phone contact to improve treatment initiation were discussed.