Glen

Johnson, David H.; Myers, Arnold

doi:10.1093/gmo/9781561592630.article.11276

Cited by 6 publications

(13 citation statements)

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“…The rising intensity of care for children with bronchiolitis appears to be a global phenomenon, now documented in Canada, the United States, 2,3 and Europe. [4][5][6] The study by Mahant and colleagues stands out as a particularly rigorous and comprehensive examination of this alarming trend. Most notably, the Mahant et al study is, to our knowledge, the first North American population-based cohort study addressing this topic.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…This study supports the notion of ASD screening as an iterative, multistep process that optimally involves multiple community stakeholders with varying levels of developmental expertise who have done the work to build trust with families. Since the American Academy of Pediatrics 2006 recommendation of universal ASD screening in primary care, 5 ASD detection has traditionally been considered the job of primary care professionals. However, emerging evidence suggests that such a strategy is inadequate overall, and particularly insufficient as a health equity measure.…”

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confidence: 99%

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Screen Often and With Trusted Community Members to Improve Autism Identification for Latine Children

2022

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Section: Conflict Of Interestmentioning

confidence: 99%

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confidence: 99%

Screen Often and With Trusted Community Members to Improve Autism Identification for Latine Children

2022

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“…The AAP policy statement regarding the identification and evaluation of children with ASD includes an algorithm describing when children should be screened and referred for a full evaluation. 25 This algorithm was built into CHICA as an ASD module. CHICA is a rule-based system that has operated in primary care pediatric clinics at the Eskenazi Health System in Indianapolis, Indiana, since 2004.…”

Section: Interventionmentioning

confidence: 99%

“…23 The AAP ASD guidance was encoded in the CHICA ASD module by creating rules that directed both surveillance and screening. 30,31 To conduct surveillance (as defined in the AAP guideline 25 ), CHICA's prescreening form asked parents whether they were concerned about the child's development or whether the child had a sibling with ASD. If both of these were true or if 1 was true…”

Section: Interventionmentioning

confidence: 99%

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Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics

Downs

Bauer²,

Saha

et al. 2019

JAMA Netw Open

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IMPORTANCE Universal early screening for autism spectrum disorder (ASD) is recommended but not routinely performed. OBJECTIVE To determine whether computer-automated screening and clinical decision support can improve ASD screening rates in pediatric primary care practices. DESIGN, SETTING, AND PARTICIPANTS This cluster randomized clinical trial, conducted between November 16, 2010, and November 21, 2012, compared ASD screening rates among a random sample of 274 children aged 18 to 24 months in urban pediatric clinics of an inner-city county hospital system with or without an ASD screening module built into an existing decision support software system.

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Effectiveness of the Extension for Community Health Outcomes Model as Applied to Primary Care for Autism

et al. 2020

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The Extension for Community Health Outcomes (ECHO) model is a widely adopted technology-based model for training primary care physicians and practitioners (PCPs) to care for patients with complex conditions. Despite its popularity, to our knowledge, direct effects of ECHO on clinical practice have not been tested in a large-scale study.OBJECTIVE To test the effectiveness of the ECHO model as applied to primary care for autism and whether it resulted in improved clinical practice, knowledge, and self-efficacy regarding autism screening and comorbidity management. DESIGN, SETTING, AND PARTICIPANTS Primary care physicians and practitioners were recruited to participate in a 6-month ECHO Autism program delivered by 1 of 10 academic medical center sites. A sequential, staggered rollout of ECHO Autism was delivered to 5 cohorts of participants (15 per site; 2 sites per cohort). Sites were randomized after recruitment to cohort/start time. Cohorts launched every 3 months. The ECHO Autism program used videoconferencing technology to connect community-based PCPs with interdisciplinary expert teams at academic medical centers. There were 148 participants (PCPs [family practice physicians, pediatricians, nurse practitioners, and physician assistants] providing outpatient services to underserved children) studied between December 2016 and November 2018. INTERVENTIONS The 6-month ECHO Autism program included twelve 2-hour sessions connecting PCP participants with an interdisciplinary expert team. Sessions included didactics, case-based learning, guided practice, and discussion. MAIN OUTCOMES AND MEASURESCoprimary outcomes were autism screening practices and comorbidity management (assessed by medical record review). Secondary outcomes were knowledge (assessed by direct testing) and self-efficacy (assessed by self-report survey). Assessments were conducted at baseline, mid-ECHO, post-ECHO, and follow-up (3 months after ECHO).RESULTS Ten sites were randomized to 1 of 5 cohorts. Participants were 82% female (n = 108), 76% white (n = 100), and 6% Hispanic or Latino (n = 8); the median age was 46 years (interquartile range, 37-55 years). Significant changes in autism screening and treatment of comorbidities in children with autism were not observed. Participants demonstrated significant improvements in knowledge (9%; 95% CI, 4-13; P < .001) and self-efficacy (29%; 95% CI, 25-32; P < .001). CONCLUSIONS AND RELEVANCEThe ECHO model was developed to increase access to high-quality health care for underserved patients with complex conditions. Study results provide support for the model in improving clinician knowledge and confidence but little support for achieving practice change.

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Glen

Cited by 6 publications

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Screen Often and With Trusted Community Members to Improve Autism Identification for Latine Children

Screen Often and With Trusted Community Members to Improve Autism Identification for Latine Children

Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics

Effectiveness of the Extension for Community Health Outcomes Model as Applied to Primary Care for Autism

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