Reducing Barriers to Autism Care in Latino Children

描述（由申请人提供）：早期自闭症谱系障碍（ASD）诊断可以改善儿童的长期发展和家庭应对这种疾病的能力。拉丁裔儿童在年龄较大时被诊断为自闭症，在出现更严重的症状时，他们和他们的家庭处于非常不利的地位。针对家庭、社区和卫生保健系统因素的干预措施有望改善少数民族儿童获得ASD诊断服务的机会。该项目的目标是开发一种基于证据的干预措施，以减少拉丁美洲人在自闭症治疗方面的种族差异。为了实现这一目标，我们将对350名典型发育儿童或自闭症儿童的拉丁裔父母进行调查，以评估拉丁裔社区对自闭症的普遍看法，并评估哪些社区因素、健康信念和医疗保健系统因素与ASD诊断延迟有关。这项调查将在自闭症治疗网络的三个地点进行：俄勒冈州波特兰市的俄勒冈健康与科学大学；科罗拉多大学/丹佛儿童医院；宾夕法尼亚大学/费城儿童医院。基于调查中发现的障碍，我们将开发一个试点社区患者导航干预，旨在减少护理障碍。这项研究将纳入职业发展计划，包括增加首席研究员在自闭症诊断和治疗、心理健康差异、介入性研究设计和社区研究领域的知识和技能。这项研究的结果将发表在同行评议的期刊上，并作为美国国立卫生研究院资助的一项提案的基础，该提案旨在对该项目设计的干预措施进行多地点测试。超过12万美国拉丁裔儿童被诊断患有自闭症谱系障碍，这个数字可能低估了真正的患病率。该项目将帮助这些儿童获得早期诊断和更好的长期预后。

DESCRIPTION (provided by applicant): Early Autism Spectrum Disorder (ASD) diagnosis improves long-term child development and families' ability to cope with this disorder. Latino children are diagnosed with ASDs at older ages and at the point of more severe symptoms, putting them and their families at significant disadvantage. Interventions addressing family, community, and health care systems factors hold promise for improving access to ASD diagnostic services for minority children. The goal of this project is to develop an evidence-based intervention to reduce ethnic differences in ASD care among Latinos. To accomplish this goal, we will develop a survey of 350 Latino parents of either typically-developing children or children with ASDs, to assess common beliefs about autism in Latino communities, and to assess which community factors, health beliefs, and health care system factors are associated with delays in ASD diagnosis. The survey will be conducted at three sites within the Autism Treatment Network: Oregon Health & Science University in Portland, Oregon; University of Colorado/The Children's Hospital in Denver; and University of Pennsylvania/Children's Hospital of Philadelphia. Based on the barriers found in the survey, we will develop a pilot community-based patient navigator intervention designed to reduce barriers to care. This research will be incorporated into a career development plan that includes increasing the Principal Investigator's knowledge and skills in the areas of autism diagnosis and treatment, mental health disparities, interventional study design, and community-based research. The results of this research will be published in peer-reviewed journals and used as the basis for an NIH-funded proposal to conduct a multi-site test of the intervention designed in this project. Over 120,000 U.S. Latino children have been diagnosed with an ASD, a figure that likely underestimates the true prevalence. This project will help such children achieve earlier diagnosis and better long-term prognosis. PUBLIC HEALTH RELEVANCE: The goal of this project is to develop an evidence-based intervention to improve rates of early diagnosis and treatment of autism spectrum disorders in Latino children. We will achieve this goal through surveying Latino parents to identify barriers to care and then developing a pilot patient navigator intervention designed to reduce the barriers that we identified. This research will be incorporated into a career development plan that includes increasing the Principal Investigator's knowledge and skills in the areas of autism diagnosis and treatment, mental health disparities, interventional study design, and community-based research.