|Title||A hybrid type I randomized effectiveness-implementation trial of patient navigation to improve access to services for children with autism spectrum disorder.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Broder-Fingert, S, Walls, M, Augustyn, M, Beidas, R, Mandell, D, Wiltsey-Stirman, S, Silverstein, M, Feinberg, E|
|Date Published||2018 03 27|
|Keywords||Autism Spectrum Disorder, Child, Child, Preschool, Comparative Effectiveness Research, Connecticut, Ethnic Groups, Female, Health Services Accessibility, Healthcare Disparities, Humans, Male, Massachusetts, Patient Navigation, Pennsylvania, Primary Health Care, Research Design|
BACKGROUND: Significant racial, ethnic, and socioeconomic disparities exist in access to evidence-based treatment services for children with autism spectrum disorder (ASD). Patient Navigation (PN) is a theory-based care management strategy designed to reduce disparities in access to care. The purpose of this study is to test the effectiveness of PN a strategy to reduce disparities in access to evidence-based services for vulnerable children with ASD, as well as to explore factors that impact implementation.
METHODS: This study uses a hybrid type I randomized effectiveness/implementation design to test effectiveness and collect data on implementation concurrently. It is a two-arm comparative effectiveness trial with a target of 125 participants per arm. Participants are families of children age 15-27 months who receive a positive screen for ASD at a primary care visit at urban clinics in Massachusetts (n = 6 clinics), Connecticut (n = 1), and Pennsylvania (n = 2). The trial measures diagnostic interval (number of days from positive screen to diagnostic determination) and time to receipt of evidence-based ASD services/recommended services (number of days from date of diagnosis to receipt of services) in those with PN compared to and activated control -Conventional Care Management - which is similar to care management received in a high quality medical home. At the same time, a mixed-method implementation evaluation is being carried out.
DISCUSSION: This study will examine the effectiveness of PN to reduce the time to and receipt of evidence-based services for vulnerable children with ASD, as well as factors that influence implementation. Findings will tell us both if PN is an effective approach for improving access to evidence-based care for children with ASD, and inform future strategies for dissemination.
TRIAL REGISTRATION: NCT02359084 Registered February 1, 2015.
|Alternate Journal||BMC Psychiatry|
|PubMed Central ID||PMC5870193|
|Grant List||R01 MH104355 / MH / NIMH NIH HHS / United States |
K23MH109673 / MH / NIMH NIH HHS / United States
R01MH104355 / MH / NIMH NIH HHS / United States
K24HD081057 / MH / NIMH NIH HHS / United States
K24 HD081057 / HD / NICHD NIH HHS / United States
K23 MH109673 / MH / NIMH NIH HHS / United States