Objective:

Attention-Deficit/Hyperactivity Disorder (ADHD) disproportionately affects socioeconomically disadvantaged children, but for unclear reasons. We examined the association between social determinants of health (SDH) and ADHD symptoms in a national sample of preschool-age children.

Methods:

We conducted exploratory factor analysis (EFA) and exploratory structural equation modeling (ESEM) with a sample of 7,565 preschool-age children from the 2016 National Survey of Children’s Health, to examine the association between ADHD symptoms and SDH.

Results:

EFA indicated a one-factor structure for ADHD symptoms, and three factors for SDH (socioeconomic status, access to basic needs, and caregiver well-being). Independently, all three SDH were significantly associated with higher ADHD symptoms. However, in the ESEM model, only worse caregiver well-being (β = .39, p < .01) was significantly associated with ADHD symptoms, and fully mediated the relationship between SDH and ADHD symptoms.

Conclusion:

Addressing caregiver well-being in preschoolers with ADHD symptoms could be an early intervention strategy.

中文翻译：

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学龄前儿童健康和多动症症状的社会决定因素

 客观的：

注意力缺陷/多动症（ADHD）对社会经济弱势儿童的影响尤为严重，但原因尚不清楚。我们在全国学龄前儿童样本中研究了健康社会决定因素 (SDH) 与 ADHD 症状之间的关联。

 方法：

我们对 2016 年全国儿童健康调查中的 7,565 名学龄前儿童进行了探索性因子分析 (EFA) 和探索性结构方程模型 (ESEM)，以检查 ADHD 症状与 SDH 之间的关联。

 结果：

EFA 显示了 ADHD 症状的单因素结构和 SDH 的三因素结构（社会经济地位、基本需求的获得和护理人员的福祉）。独立地，所有三种 SDH 均与较高的 ADHD 症状显着相关。然而，在 ESEM 模型中，只有较差的护理人员幸福感 (β = .39, p < .01) 与 ADHD 症状显着相关，并且完全调节 SDH 和 ADHD 症状之间的关系。

 结论：

解决患有多动症症状的学龄前儿童的照顾者福祉可能是一种早期干预策略。