The role of parental health literacy in paediatric ADHD treatment: An observational study from Türkiye

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Sirin H., Uzun M. E., Demirci H., Koşan Y.

British Journal of Clinical Psychology, ss.1-17, 2026 (Scopus)

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Objectives: Parental health literacy is an important issuein paediatric chronic disease, but its role in attention defi-cit hyperactivity disorder (ADHD) treatment remains un-derexplored. This study aimed to investigate health literacylevels among parents of children diagnosed with ADHDand to evaluate the relationships between these levels, par-ents' decisions to accept or refuse pharmacotherapy for theirchildren's ADHD treatment, and their children's ADHDsymptoms.Design: A total of 133 children with ADHD and their par-ents (mothers and fathers) participated in this single-centreobservational study. Participants were divided into twogroups: Group 1 (n = 68): parents who accepted pharmaco-therapy and their children who started treatment; Group2 (n = 65): parents who refused pharmacotherapy and theirchildren who did not start treatment.Methods: Parental health literacy was assessed using theEuropean Health Literacy Survey Questionnaire (HLS-EU- Q), and ADHD children's clinical characteristics wereevaluated using the Conners' Parent Rating Scale-Revised/Long (CPRS-R/L) and the Clinical Global Impression(CGI) Scale.Results: Both groups had similar sociodemographic char-acteristics and maternal and paternal health literacy levels.In Group 1, positive correlations were found between ma-ternal and paternal health literacy indices, as well as be-tween CGI-I and many subscales of the CPRS-R/L (changescores = post-treatment–pre-treatment). Additionally, inGroup 1, relationships were identified between maternal2 |SIRINet al.I N T RODUC T IONHealth literacy has emerged as a significant issue in the management of childhood chronic diseases inrecent years. Although health literacy has been defined and conceptualized variously, it encompassespersonal skills that empower individuals to acquire, understand and utilize information to make in-formed health decisions. These skills are not limited to individual behaviours but can be applied toall determinants of health, such as social and environmental (Nutbeam et al., 2018). A low level ofhealth literacy is identified as a critical risk factor for poor health outcomes in both children and adults(Vaillancourt & Cameron, 2022). Many parents may face health literacy challenges, which seem relatedto their children's health (Morrison et al., 2019). Specifically, parents with low health literacy often havelimited health knowledge (DeWalt & Hink, 2009), poorer disease management (Morrison et al., 2019)and have poor preventive care behaviours (Sanders et al., 2009).While numerous studies have explored the association between parents' health literacy and vari-ous paediatric chronic physical conditions, such as asthma (Krishnan et al., 2018), obesity (Morrisonet al., 2019) and diabetes (Pulgarón et al., 2014), it seems that very little is known about parental healthliteracy in childhood psychiatric diseases. In the field of attention deficit hyperactivity disorder (ADHD),most studies on parental health literacy appear to focus on mental health literacy. Davidson et al. (2022)reported that parents scored slightly above the moderate range in mental health literacy skills regard-ing recognizing ADHD and identifying effective help-seeking strategies. Bonanno et al. (2021) foundthat parents had more knowledge about ADHD compared to other mental health disorders. Mah andLi (2025) reported that Chinese Canadian parents had less knowledge about ADHD and more stigma-tizing beliefs than European Canadian parents, but showed an increase in knowledge and medicationacceptance following passive psychoeducation. In a study from Türkiye, Morgül et al. (2026) reportedthat only 14% of mothers could correctly recognize ADHD, emphasizing the importance of increas-ing ADHD awareness and reducing stigma. In a study on medication adherence and health literacy inADHD, Sharif et al. (2025) reported improvements in medication adherence and health literacy amongand paternal health literacy indices and many subscalesof the CPRS-R/L (pre-treatment/post-treatment/changescores), but no relationships were found between these indi-ces and CGI-I scores.Conclusions: These findings may suggest that assessingparental health literacy and promoting interventions to im-prove it could be helpful in the management of paediatricADHD treatment