Implementing a Canadian Shared-Care ADHD Program in Beijing: Barriers and Facilitators To Consider Prior To Start-Up.

Abstract

Background The ADHD Shared Care Pathways is a program that has been developed in Canada with two main strategies: (a) to implement shared care between general practitioners (GPs) and specialists, and (b) to implement stepped care in which the patient is treated at the most appropriate level of care, depending on complexity or outcome of their illness. The current study aims to identify challenges and facilitators in implementing this program in a Chinese context. Methods Two focus groups were conducted using semi-structured interviews with a total of 7 healthcare providers in Beijing. A grounded theory approach using open, axial and selective coding provided three main themes pertaining to the barriers and facilitators faced at: (1) a Social-level from of the perspectives of patients and healthcare providers; (2) at a structural-level related to both internal and external organizational environments; (3) and at the intervention-level. Results Results reveal multilayered challenges in implementing an ADHD Shared Care Pathways program for children in China. Conclusion Our study highlights the importance of consultation in a new implementation context in order to get a “lay of the land”. By extension, our results demonstrate areas for service development and further research.