Improving Family Navigation for Children With Autism: A Comparison of Two Pilot Randomized Controlled Trials.
Improving Family Navigation for Children With Autism: A Comparison of Two Pilot Randomized Controlled Trials.
复制标题
改善自闭症儿童的家庭导航：两项随机对照试验的比较。
DOI：
10.1016/j.acap.2020.04.007
复制
发表时间：
2021-03
影响因子：
3.1
通讯作者：
Broder-Fingert S
中科院分区：
文献类型：
--
作者：
Feinberg E;Kuhn J;Eilenberg JS;Levinson J;Patts G;Cabral H;Broder-Fingert S
家庭导航（FN）是一项护理管理战略，帮助家庭克服护理系统和个人层面的障碍。我们以前证明了FN的可行性，可接受性和潜在的有效性，以增加低收入，少数民族儿童的自闭症相关的诊断服务，并减少时间。在本文中，我们描述了FN的修改，以回应我们的第一个试点随机对照试验（RCT）中提出的问题，然后在第二个试点RCT中评估这些修改。一个咨询小组建议修改招募程序和研究条件。40名患有自闭症相关问题的父母-子女二人组参与者随机接受改良的常规护理（UC）或改良的FN。我们比较了第一个和第二个试验性随机对照试验在以下方面是否存在差异：受试者招募、对临床护理的满意度以及及时完成诊断评估。在修改后的方案下，招募情况有所改善，潜在合格家庭拒绝（19.5% vs. 4.8%，p <0.05）或被排除在研究招募之外（43.6% vs. 0%，p < 0.01）。比较第一项和第二项初步RCT，无论研究组如何，第二项初步研究中的家庭更有可能完成诊断评估（UC：HR 3.41，95% CI [1.20，9.68]; FN：HR 2.64，95% CI [1.31，5.30]），并报告对临床护理的满意度更高。在第二项初步试验中，与UC相比，FN继续增加完成诊断评估的可能性（HR：2.57; 95% CI [1.22，5.40]）。易于实施的系统级增强改善了研究招募、护理满意度和诊断评估的完成。经过加强，新军继续向家庭提供福利。
Family Navigation (FN), a care management strategy, helps families overcome systems and person-level barriers to care. We previously demonstrated FN’s feasibility, acceptability, and potential efficacy for increasing access and reducing time to autism-related diagnostic services among low-income, minority children. In this paper, we describe modifications to FN in response to concerns raised in our first pilot randomized controlled trial (RCT), and then assess these modifications in a second pilot RCT. An advisory group recommended modifications to recruitment procedures and study conditions. 40 parent-child dyad participants with autism-related concerns were randomized to receive modified usual care (UC) or modified FN. We compared whether the first and second pilot RCTs differed in: participant enrollment, satisfaction with clinical care, and timely completion of the diagnostic assessment. Recruitment improved under the modified protocol with significantly fewer potentially eligible families refusing (19.5% vs. 4.8%, p < .05) or being excluded from study enrollment (43.6% vs. 0%, p < 0.01). Comparing the first and second pilot RCTs, regardless of study arm, families in the second pilot were more likely to complete diagnostic assessment (UC: HR 3.41, 95% CI [1.20, 9.68]; FN: HR 2.64, 95% CI [1.31, 5.30]) and report greater satisfaction with clinical care. In the second pilot, compared to UC, FN continued increase the likelihood of completing the diagnostic assessment (HR: 2.57; 95% CI [1.22, 5.40]). Easy-to-implement system-level enhancements improved study recruitment, satisfaction with care, and completion of a diagnostic assessment. With enhancement, FN continued to confer benefits to families.
登录
查看更多内容
影响因子：
8
作者：
Manning, Susan E.;Davin, Carol A.;Smith, Lauren A.
通讯作者：
Smith, Lauren A.
影响因子：
3.8
作者：
Feinberg, Emily;Abufhele, Marcela;Silverstein, Michael
通讯作者：
Silverstein, Michael
DOI：
10.1016/j.jaac.2012.02.019
发表时间：
2012-05-01
影响因子：
13.3
作者：
Kasari, Connie;Gulsrud, Amanda;Hellemann, Gerhard
通讯作者：
Hellemann, Gerhard
DOI：
10.15585/mmwr.ss6706a1
发表时间：
2018-04-27
期刊：
Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002)
影响因子：
--
作者：
Baio J;Wiggins L;Christensen DL;Maenner MJ;Daniels J;Warren Z;Kurzius-Spencer M;Zahorodny W;Robinson Rosenberg C;White T;Durkin MS;Imm P;Nikolaou L;Yeargin-Allsopp M;Lee LC;Harrington R;Lopez M;Fitzgerald RT;Hewitt A;Pettygrove S;Constantino JN;Vehorn A;Shenouda J;Hall-Lande J;Van Naarden Braun K;Dowling NF
通讯作者：
Dowling NF
影响因子：
6.2
作者：
Freeman HP;Rodriguez RL
通讯作者：
Rodriguez RL