Screening and Linkage to Services for Autism
Condition: Autism Spectrum Disorders
MeSH terms: Autistic Disorder; Autism Spectrum Disorder
Study type: Interventional

Summary: 
      The SaLSA (Screening and Linkage to Services for Autism) study will test whether patient
      navigation can help disadvantaged families obtain earlier diagnosis and treatment for their
      children who have had a positive screening test for autism spectrum disorder. Half of the
      families will be offered help from an autism patient navigator. The other half will receive
      standard care.
    

Detailed description: 
      Despite its relatively high rate of occurrence, autism spectrum disorder (ASD) is
      under-diagnosed and under-treated in young children, particularly in minority and
      disadvantaged populations. Although screening for ASD in the primary care setting is
      recommended as best practice, inadequate attention has been paid to addressing important
      obstacles to early recognition of ASD, including barriers to referral after positive
      screening, completion of diagnostic evaluations, and receipt of treatment. Patient navigation
      was originally developed to reduce health care disparities. The patient navigator guides
      patients with suspicious findings (e.g., a positive screening test) through and around
      barriers to care to ensure timely diagnosis and treatment. Patient navigation has improved
      receipt of preventive care among low-income, minority children but has not been tested for
      improving early identification and treatment of autism spectrum disorders. The goal of this
      study is to test the effectiveness and feasibility of patient navigation to facilitate autism
      screening follow-up, diagnostic evaluation, and linkage to early intervention in a very
      young, disadvantaged, minority population. To increase patient navigation's potential for
      widespread application and public health impact, this study uses the Reach, Effectiveness,
      Adoption, Implementation and Maintenance (RE-AIM) framework, a set of criteria for
      translating research into action, to guide planning and evaluation. The intervention's Reach,
      Effectiveness, Adoption, Implementation and Maintenance over time will be examined.
    

Intervention name(s): Patient Navigation
Intervention type(s): Behavioral
Intervention description(s): The Autism Patient Navigator (APN) will interview families to determine system and individual barriers facing the family at each stage of the care process. The APN will help families to overcome any identified barriers through education, coaching, social support, interpretation or translation, linkage to resources (e.g., for obtaining insurance) or logistical support (e.g., scheduling appointments, providing reminders, arranging transportation), in order to ensure timely diagnostic evaluation / eligibility determination; educate the family about autism, tests and treatments; and offer psychosocial support.
Other intervention name(s): Autism Patient Navigation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Health Services Research
Keywords: Patient Navigation; Health Disparities; Coordination of Services; Early Intervention (Education); Health Services Accessibility; Patient Advocacy