Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario.
Autism spectrum disorder
Cultural sensitivity
Developmental disabilities
Early detection
Health services
Program evaluation
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
31 Mar 2022
31 Mar 2022
Historique:
received:
31
10
2021
accepted:
16
03
2022
entrez:
1
4
2022
pubmed:
2
4
2022
medline:
5
4
2022
Statut:
epublish
Résumé
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario. This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives. Between September 2018-February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program's success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder. The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations.
Sections du résumé
BACKGROUND
BACKGROUND
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario.
METHODS
METHODS
This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives.
RESULTS
RESULTS
Between September 2018-February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program's success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder.
CONCLUSIONS
CONCLUSIONS
The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations.
Identifiants
pubmed: 35361202
doi: 10.1186/s12913-022-07789-7
pii: 10.1186/s12913-022-07789-7
pmc: PMC8973535
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
426Informations de copyright
© 2022. The Author(s).
Références
J Clin Child Adolesc Psychol. 2009 May;38(3):439-50
pubmed: 19437303
Chronic Dis Inj Can. 2012 Mar;32(2):90-100
pubmed: 22414306
J Natl Med Assoc. 2007 Jun;99(6):609-19
pubmed: 17595929
Health Promot Pract. 2005 Apr;6(2):134-47
pubmed: 15855283
J Dev Behav Pediatr. 2008 Jun;29(3):152-60
pubmed: 18349708
J Immigr Minor Health. 2015 Dec;17(6):1895-905
pubmed: 25742880
Med Care. 2014 Oct;52(10 Suppl 3):S64-70
pubmed: 25215921
Int J Soc Psychiatry. 2008 Mar;54(2):180-90
pubmed: 18488410
J Dev Behav Pediatr. 2009 Oct;30(5):447-59
pubmed: 19823139
J Am Coll Radiol. 2009 May;6(5):307-16
pubmed: 19394571
J Autism Dev Disord. 2019 May;49(5):2173-2183
pubmed: 30701434
J Autism Dev Disord. 2016 Aug;46(8):2720-2733
pubmed: 27193183
Eur Child Adolesc Psychiatry. 2017 Jun;26(6):623-647
pubmed: 28054223
J Autism Dev Disord. 2021 Nov;51(11):3937-3945
pubmed: 33423215
Paediatr Child Health. 2019 Feb;24(1):e57-e65
pubmed: 30906197
J Nurs Scholarsh. 2004;36(2):161-6
pubmed: 15227764
Disabil Rehabil. 2010;32(16):1373-5
pubmed: 20205544
J Autism Dev Disord. 2012 Sep;42(9):1967-73
pubmed: 22271196
Can J Psychiatry. 2004 Mar;49(3):192-9
pubmed: 15101502
Autism. 2017 Apr;21(3):301-309
pubmed: 27132013
Autism. 2014 Jul;18(5):583-97
pubmed: 23787411
J Dev Behav Pediatr. 2020 Feb/Mar;41(2):95-103
pubmed: 31567722
Pediatrics. 2005 Dec;116(6):1480-6
pubmed: 16322174
Health Psychol. 2011 May;30(3):342-50
pubmed: 21553978
MMWR Surveill Summ. 2021 Dec 03;70(11):1-16
pubmed: 34855725
J Clin Child Adolesc Psychol. 2008 Jan;37(1):8-38
pubmed: 18444052
Disabil Rehabil. 2012;34(23):2007-17
pubmed: 22455458
Ment Retard Dev Disabil Res Rev. 2005;11(2):110-5
pubmed: 15977313
Dev Psychopathol. 2008 Summer;20(3):775-803
pubmed: 18606031
J Pediatr. 2015 Aug;167(2):460-6
pubmed: 26210844
Paediatr Child Health. 2019 Nov;24(7):424-443
pubmed: 31660041
Mol Autism. 2018 Mar 6;9:16
pubmed: 29541438
BMC Pediatr. 2016 Mar 16;16:42
pubmed: 26983782