Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario. Methods This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives. Results Between September 2018–February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program’s success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder. Conclusions The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations.
Health equity allows people to reach their full health potential and access and receive care that is fair and suitable to them and their needs regardless of where they live, what they have, or who they are. To achieve health equity, equity in healthcare focuses on the role of the health system to provide timely and appropriate care. When viewed in the context of a National Autism Strategy, this extends to ensuring access to the resources that each Autistic person requires to meet their health needs, such as an autism diagnosis, services, and supports. Based on the equity panel discussion held at the Canadian Autism Leadership Summit 2020, this article reflects on the current disparities and barriers to achieving health equity in a National Autism Strategy, and outlines ways to address them. Disparities to equitable care within the autism community extend from the level of support needs of an individual to how those intersect with several key determinants of health including: geography, culture, gender, and socioeconomic status. Notably, barriers arise due to a “lack of” theme, including lack of awareness, knowledge, access, and voice. Four reoccurring ideas were identified for how to address inequities in health care for Autistic people. First, allocate resources for regional or in-community endeavours; second, improve Autistic representation and connection; third, establish a community of allies to advocate and collaborate; and fourth, establish leadership within the community and government to make disability a priority for Canada. To achieve equity in health care in a National Autism Strategy, we need to look at the intersectionality of autism with the key determinants of health. Moreover, to effectively engage with the government, health professionals, and the public, the autism community should strive to find a unified and diverse voice. And finally, conversation must turn to action.
Objective The objective is to determine the impact of a health education intervention on self-rated health knowledge, levels of stress and anxiety, and ability to find and access school resources for international students studying at a Canadian University and College. Participants and setting This is a pre- and post-intervention survey. Undergraduate and graduate international students on the shared campus of Durham College and Ontario Tech University in Oshawa, Ontario were included. Interventions International students participating in this study received two structured visits, scheduled two weeks apart. At the start of the first visit, students completed a baseline survey which included questions on self-rated health knowledge, stress levels, and ability to access school resources. At this visit, students received 30 minutes of structured health education from a registered nurse on the topics of sexual health and adult immunizations. At the second visit, students received 30 minutes of structured teaching from the registered nurse on the topics of mental health, COVID-19, and campus resources. Upon the completion of this teaching, students completed a post-intervention survey with the same questions as the pre-survey, to gauge for changes related to the intervention. Results T-values were calculated for each survey item from the pre and post-survey. These t-values were used as the outcome measure to determine changes in health knowledge, stress levels, and ability to access resources following the intervention. In total, there were 202 participants. Statistical analysis showed significant t-values for all survey items in the pre- and post-analysis. Following the education intervention, the highest t-values were noted in self-rated sexual health knowledge (t-value 16.80, p < 0.001), ability to find and access school resources (t-value 16.14, p < 0.001), and current level of stress/anxiety in regard to being in a new country (t-value 14.04, p < 0.001). Conclusion Following a structured health education intervention, international students reported significant increases in self-rated health knowledge for specific topics, ability to find and access school resources, ability to get help for a mental health issue, and significant decreases in self-rated stress/anxiety. These results can support further exploration of health education in international student populations to ensure these students are adequately informed and supported when arriving in a new country.
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