Presenter Biography

My name is Yesenia Morales and I am currently finishing my undergraduate degree at Portland State University. I am majoring in public health with an emphasis on community promotion with a minor in Spanish. I am a research assistant at Oregon Health & Science University researching autism care, health disparity, and accessibility in underserved communities.

Institution

PSU

Program/Major

Public health community health promotion

Degree

BA

Presentation Type

Poster

Start Date

6-4-2022 2:57 PM

End Date

6-4-2022 3:03 PM

Keywords

Autism, underserved families, screeners and accessibility

Abstract

Background: Mobile-health (mHealth; using mobile devices) screening tools for autism are becoming more prevalent, and have potential benefits such as video content, eye tracking, and adaptive design. However, it is unclear whether such tools will ameliorate disparities in access to autism diagnosis and treatment for children from under-privileged backgrounds, instead of improving treatment only for those already advantaged in autism care.

Objective: To understand factors affecting equity in use of mHealth autism screening tools from the perspective of primary care providers (PCPs) and Early Intervention/Early Childhood Special Education providers (EIPs).

Design/Methods: We conducted qualitative interviews about mHealth autism screening tools, with 9 PCPs and 9 EIPs in 6 states. Interviews were conducted by a PCP or Speech Language Pathologist. The interview guide was reviewed by parents and 2 PCPs for content validity. Providers were given 3 hypothetical scenarios, in which a parent presents to care with test results they drew from autism screeners. In each scenarios the provider was presented with one of 10 online or app based screening tool screeners identified through a comprehensive search by the study team. They were to discuss their clinical approach and critically review the tool’s ability to meet family needs. Each transcript was audio-recorded, transcribed, and coded by team members using QSR nVivo 12; coding differences were resolved through mutual discussion. A phenomenological approach was used to develop key themes and recommendations.

Results: PCPs and EIPs identified 4 themes and 17 subthemes describing mHealth benefits and challenges (Table). Clinical and business factors included integration with the EHR, role in clinical efficiency, and scope of practice. Validity and trustworthiness factors included face validity, tool recognition/familiarity, privacy and security concerns, and credibility/authority. Family interaction factors included tool starts a conversation about ASD, supports family advocacy, provides information, and resources, and affects family anxiety or provides/emotional support. Accessibility factors included time burden, English proficiency/language issues, cultural inclusivity, and literacy/educational level. Providers suggested modifications such as portraying diverse families, reducing the reading level of text and making tools shorter to better fit clinical context.

Conclusion:mHealth ASD screening tools have many benefits and challenges when reaching underrepresented families. Shedding light on these challenges can inform more equitable tool design.

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Apr 6th, 2:57 PM Apr 6th, 3:03 PM

Provider Perspectives on Benefits and Challenges of mHealth Autism Screeners​ in Underserved Families

Background: Mobile-health (mHealth; using mobile devices) screening tools for autism are becoming more prevalent, and have potential benefits such as video content, eye tracking, and adaptive design. However, it is unclear whether such tools will ameliorate disparities in access to autism diagnosis and treatment for children from under-privileged backgrounds, instead of improving treatment only for those already advantaged in autism care.

Objective: To understand factors affecting equity in use of mHealth autism screening tools from the perspective of primary care providers (PCPs) and Early Intervention/Early Childhood Special Education providers (EIPs).

Design/Methods: We conducted qualitative interviews about mHealth autism screening tools, with 9 PCPs and 9 EIPs in 6 states. Interviews were conducted by a PCP or Speech Language Pathologist. The interview guide was reviewed by parents and 2 PCPs for content validity. Providers were given 3 hypothetical scenarios, in which a parent presents to care with test results they drew from autism screeners. In each scenarios the provider was presented with one of 10 online or app based screening tool screeners identified through a comprehensive search by the study team. They were to discuss their clinical approach and critically review the tool’s ability to meet family needs. Each transcript was audio-recorded, transcribed, and coded by team members using QSR nVivo 12; coding differences were resolved through mutual discussion. A phenomenological approach was used to develop key themes and recommendations.

Results: PCPs and EIPs identified 4 themes and 17 subthemes describing mHealth benefits and challenges (Table). Clinical and business factors included integration with the EHR, role in clinical efficiency, and scope of practice. Validity and trustworthiness factors included face validity, tool recognition/familiarity, privacy and security concerns, and credibility/authority. Family interaction factors included tool starts a conversation about ASD, supports family advocacy, provides information, and resources, and affects family anxiety or provides/emotional support. Accessibility factors included time burden, English proficiency/language issues, cultural inclusivity, and literacy/educational level. Providers suggested modifications such as portraying diverse families, reducing the reading level of text and making tools shorter to better fit clinical context.

Conclusion:mHealth ASD screening tools have many benefits and challenges when reaching underrepresented families. Shedding light on these challenges can inform more equitable tool design.