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. 2019 Jul;23(5):1288-1299.
doi: 10.1177/1362361318808460. Epub 2018 Nov 8.

A mixed-methods process evaluation of Family Navigation implementation for autism spectrum disorder

Sarabeth Broder-Fingert  1 , Sarah Qin  2 , Julia Goupil  2 , Jessica Rosenberg  2 , Marilyn Augustyn  1 , Nate Blum  3 , Amanda Bennett  3 , Carol Weitzman  4 , James P Guevara  3 , Ada Fenick  4 , Michael Silverstein  1 , Emily Feinberg  1   5
Affiliations

A mixed-methods process evaluation of Family Navigation implementation for autism spectrum disorder

Sarabeth Broder-Fingert et al. Autism. 2019 Jul.

Abstract

There is growing interest in Family Navigation as an approach to improving access to care for children with autism spectrum disorder, yet little data exist on the implementation of Family Navigation. The aim of this study was to identify potential failures in implementing Family Navigation for children with autism spectrum disorder, using a failure modes and effects analysis. This mixed-methods study was set within a randomized controlled trial testing the effectiveness of Family Navigation in reducing the time from screening to diagnosis and treatment for autism spectrum disorder across three states. Using standard failure modes and effects analysis methodology, experts in Family Navigation for autism spectrum disorder (n = 9) rated potential failures in implementation on a 10-point scale in three categories: likelihood of the failure occurring, likelihood of not detecting the failure, and severity of failure. Ratings were then used to create a risk priority number for each failure. The failure modes and effects analysis detected five areas for potential "high priority" failures in implementation: (1) setting up community-based services, (2) initial family meeting, (3) training, (4) fidelity monitoring, and (5) attending testing appointments. Reasons for failure included families not receptive, scheduling, and insufficient training time. The process with the highest risk profile was "setting up community-based services." Failure in "attending testing appointment" was rated as the most severe potential failure. A number of potential failures in Family Navigation implementation-along with strategies for mitigation-were identified. These data can guide those working to implement Family Navigation for children with autism spectrum disorder.

Keywords: autism spectrum disorders; qualitative research.

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Conflict of interest statement

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Process of implementing Patient Navigation.
Figure 2.
Figure 2.
Navigator training.
Figure 3.
Figure 3.
Diagnostic assessment.
See this image and copyright information in PMC

References

    1. Abujudeh HH, Danielson A and Bruno MA (2016) A patient-centered radiology quality process map: opportunities and solutions. American Journal of Roentgenology 207(5): 940–946. - PubMed
    1. Acharya K, Meza R and Msall ME (2017) Disparities in life course outcomes for transition-aged youth with disabilities. Pediatric Annals 46(10): e371–e376. - PubMed
    1. Ali-Faisal SF, Colella TJF, Medina-Jaudes N, et al. (2017) The effectiveness of patient navigation to improve healthcare utilization outcomes: a meta-analysis of randomized controlled trials. Patient Education and Counseling 100(3): 436–448. - PubMed
    1. Angell AM and Solomon O (2017) “If I was a different ethnicity, would she treat me the same?”: Latino parents’ experiences obtaining autism services. Disability & Society 32(8): 1142–1164. - PMC - PubMed
    1. Ashley L, Armitage G and Taylor J (2017) Recognising and referring children exposed to domestic abuse: a multi-professional, proactive systems-based evaluation using a modified Failure Mode and Effects Analysis (FMEA). Health & Social Care in the Community 25(2): 690–699. - PubMed

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