Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 17, 2025
Date Accepted: Jul 11, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Parental challenges in raising pre-schoolers with attention-deficit/hyperactivity disorder in mainland China’s first-tier cities: a qualitative study
ABSTRACT
Background:
First-tier cities in mainland China present unique challenges for raising children with attention-deficit/hyperactivity disorder (ADHD) due to rapid urbanization, intense academic pressure, and distinct sociocultural dynamics.
Objective:
This study aimed to explore the comprehensive challenges faced by parents raising pre-schoolers with ADHD in these metropolitan contexts.
Methods:
Online semi-structured focus group interviews were conducted with 13 parents (12 mothers, 1 father) of preschool children with ADHD in first-tier cities in mainland China between March and July 2024. All interviews were audio-recorded and transcribed verbatim. Data were analyzed using framework analysis guided by Bronfenbrenner's ecological systems theory.
Results:
Challenges emerged across six major themes: (1) individual psychological and behavioral challenges; (2) microsystem challenges in family and school interactions; (3) mesosystem difficulties in family-school-hospital coordination; (4) exosystem barriers in work-family balance and healthcare access; (5) macrosystem challenges from societal stigma and educational values; and (6) chronosystem impacts from historical and social changes.
Conclusions:
Parents face multi-layered challenges in raising preschoolers with ADHD, particularly regarding access to specialized healthcare services, navigation of educational systems, and utilization of culturally appropriate interventions. Future initiatives should focus on enhancing healthcare resource accessibility, developing culturally sensitive support programs, implementing systematic educational accommodations, and promoting broader societal awareness of ADHD in mainland China. Clinical Trial: NA
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