Training Promotores De SALUD to Increase Awareness of Autism Spectrum Disorder in Latino Communities in Cincinnati, OH

Background: Research indicates that Latino children: 1) receive an Autism Spectrum Disorder (ASD) diagnosis less often and 2-2.5 years later than non-Hispanic Whites, 2) are more likely to be diagnosed with severe ASD, and 3) have more unmet service needs. Thus, there is a need for effective, affordable, and culturally appropriate interventions for Latino children and their families to increase ASD knowledge. Promotores de salud have been found to be critical participants in prevention, health promotion, and the delivery of care in the Latino community. A promotores model used in ASD awareness education has the potential for enhancing healthcare access and earlier ASD identification among Latino children resulting in improved long-term outcomes.

Objectives: To pilot a promotores de salud intervention to increase ASD awareness in Latino communities.

Methods: We recruited 8 promotores who met the inclusion criteria of being Latino(a), having Spanish as primary language, at least 3^rd grade reading level, and possessing leadership qualities identified by their community leaders. The first aim of the study was to conduct a promotores training on early signs of ASD and resources founded on a curriculum-based manual that was adapted from the Autism Promotor Manual (Spanish version/UCLA and Autism Speaks). The investigators tailored it to Cincinnati/Northern Kentucky developmental and community resources. The focus of the 15-hour training was to prepare promotores to conduct community outreach and education on developmental milestones, ASD and Developmental Disabilities (DD), parental advocacy, and system navigation. We also used the “Learn the Signs. Act Early” booklet as a reference for the developmental milestones training. The key outcomes of this aim included increased ASD knowledge and acceptability (satisfaction) with the training by promotores. The second aim was to pilot test an approach to disseminate ASD awareness education by promotores teaching other Latino community members. The key outcomes included feasibility (spread of awareness training) and acceptability (satisfaction) with the promotores approach, and increase in ASD knowledge by community participants.

Results: For the first aim, acceptability of the promotores training survey (n=8) indicated high satisfaction with the training and curriculum. Using a 5-point Likert Scale, the majority of the promotores strongly agreed with the four survey statements: “the presentation helped me learn better ways to help my children learn and grow”; “the new things I learned were helpful to me”; “after hearing the presentation I want my child to be regularly screened for his/her learning and growing”; and “I would recommend this presentation to others”. We used the paired samples t-test and found no significant changes in pre-post ASD knowledge among the 8 promotores. For the second aim, 120 Latino community members participated in the ASD awareness education and they rated the promotores model with high satisfaction (e.g., 100% would recommend this presentation to others) and demonstrated significantly increased pre-post ASD knowledge (p < .01).

Conclusions: Since the promotores model was highly acceptable and demonstrated significant increased knowledge in ASD among the Latino community, our next step is to develop a promotores “train the trainer” approach to disseminate the ASD knowledge exponentially.