Adapting and Testing a Parent Education Program in Colombia

Background: ASD affects approximately 1% of the world’s population and many children with ASD around the globe, including in Latin America are not receiving the supports needed due to services being limited or not available. In collaboration with a team from the Universidad Nacional de Colombia, Bogota we adapted and pilot tested a parent educational intervention, Parents Taking Action(originally developed for Latino immigrant parents of children with ASD in the USA) for parents in Colombia. The intervention uses community health workers or promotoras which is a mode of intervention widely used internationally and is a cost-effective way to deliver education about health conditions and disabilities.

Objectives: In this study we compared two groups: families who received the intervention delivered by parents of children with ASD (parent promotoras), and families who received the intervention delivered by therapists in training (student promotoras). Our research questions are 1) did parents improve on parent outcomes between pre and post-test in the overall sample? and 2) were there differences in parent improvement between those who had parent promotoras and those who had student promotoras?

Methods: Parents of children with ASD were recruited through an inclusive public school in Bogota, and 26 were enrolled in the study and randomized to the 2 groups. Parent outcome measures included the Family Outcome Scale (FOS), the Center for Epidemiological Studies Depression Scale (CES-D) and a scale developed by the authors to measure use of evidence- based strategies. Paired sample t-tests were used to analyze pre and post-test changes and repeated measures of analysis of covariance (ANCOVA) were used to analyze differences between the 2 groups.

Results: Twenty parents completed the study indicating a 77% retention rate. Overall sample results show that parents improved on subscales from the FOS: Understanding child’s strengths and needs, helping child develop and learn, and having support systems between pre and post-test. Also parents improved in their use of evidenced-based strategies, and reported fewer depressive symptoms. We found that outcomes differed by group, parents who had student promotoras reported fewer depressive symptoms at post-test, and improved on helping their child develop and learn, and having support systems, while parents who had parent promotoras improved on understanding their child’s strength and needs. Both groups improved on the use of evidence-based strategies.

Conclusions: Our findings suggest that using promotoras to deliver parent education shows promise with improving parent outcomes for parents of children with ASD in Latin America. Furthermore, both parent and student promotoras led to positive changes in parent outcomes. However, there were more positive outcome results for parents who had student promotoras. Because students can often participate as part of an internship for their professional training, these findings demonstrate a promising parent education intervention that can be cost-effective.