Results
ADHD
Across a 6-month period from June to November, 1,105 children aged 3–8 years old attended a well-child visit at one of the primary care clinics. A total of 202 (18.28%) screening forms were returned. Examination of returned forms indicated that the majority of parents (59.41%) opted out of completing the adult ADHD screener. Among the 82 families who returned and completed the screening packet, 17 (20.73%) families screened positive (i.e., both parent and child had elevated ADHD symptoms). Another 14.6% of families had either parent (7.3%) or child (7.3%) screen positive for elevated ADHD symptoms (but not both), and 50% of families had no elevated symptoms in either parent or child. Overall, initial efforts at implementing a protocol to screen for parent and child ADHD in pediatric primary care yielded low screening completion rates. However, the positive screening rate suggests encounters with multiplex ADHD families in primary care may be common.Stakeholder feedback provided context and helped further our understanding of challenges and strategies to overcome barriers to screen and treat multiplex ADHD families in primary care. Thematic analysis identified the following themes: 1) divergence between provider enthusiasm and parent hesitation; 2) parent preference versus logistic reality of providers; 3) centering the experiences of people with marginalized identities; and 4) sensitivity when discussing parent mental health and medication. These themes are discussed below and excerpts are included for illustrative purposes.