Evaluation of a Population Screening Program Based on Paediatrician and Families Degree of Satisfaction

Background:

Previous studies carried out by the Institute of Health CarlosIII of Spain showed a significant delay in obtaining an definitive ASD diagnosis however it was proven that a Population Autism Screening Program into the Public Health System using the MCHAT can reduce significantly the time needed to obtain it. One of aspects that plays an important role in decision-making for the Health Policies is the satisfaction of the state holders with this kind of programs and this was the main reason to carried out this work.

Objectives: To evaluate the grade of acceptability and satisfaction of the AutismScreeningProgram by families and paediatricians as the main state holders. To evaluate the strengths and weaknesses of the AutismScreeningProgram. To improve its future implementation in our country.

Methods:

Population target: 75 medical professionals (30 paediatricians and 45 nurses) and 818 families (a randomized sampling selection from 2908)
Procedure: Data is collected through  two different questionnaires designed in based on the following variables:
1. Paediatrician/Nurse Variables: Research team general strategy, information given in  workshops about program structure and procedure, importance of  periodical reports of results, adequacy of the informed consent and the M-CHAT themselves, judgment on parents satisfaction, consequent improvement of their knowledge and surveillance of sociocommunicative early development, progress on the coordination with Early Intervention social and educational services. Also it was explored the extra time spent per child to screen ASD and their opinion about their feasibility for a future compulsory implementation of the program. 2. Family Variables : Paediatricians explanations, Informed consent and MCHAT questionnaire, improvement of awareness of  early sociocommunicative development in their children, letter they had received regarding their child results, telephone interview in positive cases, professionals involved in the assessment and diagnosis, diagnosis report , documents of public Early Intervention Services, their access and availability, agreement with the future compulsory instauration of the program, general satisfaction with the program and with the research team.

Answers stand on Likert form where 0 is the lowest score and 4 the highest.
Questionnaires were sent and received by mail Questionnaires were sent back anonymously. The statistical analysis was carried out by STATA.10 (means and CI 95%)

Results:

Paediatrician/Nurses participation rate: 34/75 (45.33%)
Families participation rate: 200/818 (24.44%)
Most of the questions received the highest scores: 3 and 4. The aspects that were most positively evaluated by paediatricians/nurses were their impression about parents opinion about the screening program (mean=3.70[3.51-3.90]), their judgment about its future implementation (mean=3.54[3.34-3.75]) and the research team strategy (mean=3.45[3.15-3.74]). The lowest scores were the improvement of coordination with Early Intervention Services (mean=2.87[2.5-3.23]), and the support received by NHS Managers of (mean=2.90[2.54-3.26]). Mean extra time per child 8.72min. Families: highest score was their will on future implementation of the program (mean=3.92[3.82-4.0]) and the lowest score the facilitation to access to Early Intervention programs (mean=2.22[0.84-3.29]).

Conclusions: Main state holders of the program are highly satisfied with the AutismScreening Program. This result should be had into account by Health Policy makers for future strategies on ASD early detection.