Abstract
A mixed-methods randomized controlled trial pilot study evaluated an educational curriculum focused on the medical needs of transition-age youth (TAY) with autism (ASD) for family nurse practitioner students. Fourteen out of a cohort of 16 (87.5%) nursing students consented to participate in the study and were randomly assigned to either a waitlist control group (WLC) (n = 8) or an intervention group (INT) (n = 6). Three measures were used to determine pre- and post-intervention levels of self-efficacy, knowledge, and attitudes. Quantitative and qualitative data provide preliminary support that participation in intervention may improve and enhance knowledge and level of self-efficacy in working with TAY with ASD.
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Aylott, J. (2010). Improving access to health and social care for people with autism. Nursing Standard, 24(27), 47–56.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of autism spectrum disorder among children ages years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MWWR Surveillance Summary, 67, 1–23.
Bambini, D., Washburn, J., & Perkins, R. (2009). Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment. Nursing Education Perspectives, 30(2), 79–82.
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavior change. Psychological Review, 84(2), 191–215.
Bandura, A. (1994). Self-efficacy. In V. S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71–81). New York: Academic Press. Retrieved from http://www.des.emory.edu/mfp/BanEncycy.html.
Bauman, M. L. (2010). Medical comorbidities in autism: Challenges to diagnosis and treatment. Neurotherapeutics, 7(3), 320–327.
Betz, C. L. (2013). Health transition for adolescents with special health care needs: Where is nursing? Nursing Outlook, 61(5), 258–265. https://doi.org/10.1016/j.outlook.2012.08009.
Birden, H., Glass, N., Wilson, I., Harrison, M., Usherwood, T., & Naas, D. (2013). Teaching professionalism in medical education: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Medical Teacher, 35(7), e1252–e1266. https://doi.org/10.3109/0142159X.2013.789132.
Bruder, M. B., Kerins, G., Mazzarella, C., Sims, J., & Stein, N. (2012). Brief report: The medical care of adults with autism spectrum disorders: Identifying the needs. Journal of Autism and Developmental Disorders, 42(11), 2498–2504.
Buie, T., Campbell, D., Fuchs, G., Furuta, G., Levy, J., Van de Water, J., et al. (2010). Evaluation, diagnosis and treatment of gastrointestinal disorders in individuals with ASDs: A consensus report. Pediatrics, 125(Suppl 1), S1–S18.
Cooley, W. C. (2013). Adolescent health care transition in transition. Journal of the American Medical Association (JAMA) Pediatrics, 167(10), 897–899.
Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10), 963–973.
Croen, L. A. (2006). A comparison of healthcare utilization costs of children with and without autism spectrum disorders in a large group model health plan. Pediatrics, 118(4), 1203–1211.
Flood, L. N., Bulgrin, A., & Morgan, B. L. (2013). Piecing together the puzzle: Development of the societal attitudes towards autism (SATA) scale. Journal of Research in Special Education, 13(2), 121–128. https://doi.org/10.1111/j.1471-3802.2011.01224.x.
Goldenberg D., Andrusyszyn, M. A., & Iwasiw, C. (2005). The effect of classroom simulation on nursing students’ self-efficacy related to health teaching. Journal of Nursing Education, 44(7), 310–314.
Hansen, L. K. (2015). Development and validation of a survey of knowledge of autism spectrum disorder (master’s thesis). Paper 141. Retrieved from https://aquila.usm.edu/masters_theses/141/.
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research Electronic Data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Information, 42(2), 377–381.
Havercamp, S. M., Ratliff-Schaub, K., Navas-Macho, P., Johnson, C. N., Bush, K. L., & Souders, H. T. (2016). Preparing tomorrow’s doctors to care for patients with autism spectrum disorder. Intellectual and Developmental Disabilities, 54(3), 202–216.
Iannuzzi, D. A., Cheng, E. R., Broder-Fingert, S., & Bauman, M. L. (2014). Brief report: Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders, 45(4), 1096–1102. https://doi.org/10.1007/s10803-014-2251-2.
Isacksen, J., Bryn, V., Diseth, T. H., Heiberg, A., Schjølberg, S., & Skjeldal, O. H. (2012). Children with autism spectrum disorders—The importance of medical investigations. European Journal of Paediatric Neurology, 17(1), 68–76.
Kenney, J. W. (2006). Theory-based advanced nursing practice. In W. K. Cody (Ed.), Philosophical and theoretical perspectives for advanced nursing practice (pp. 295–309). Sudbury: Jones and Bartlett.
Kogan, M. D., Strickland, B. B., Blumberg, S. J., Singh, G. K., Perrin, J. M., & van Dyck, P. C. (2008). A national profile of the health care experiences and family impact of autism spectrum disorder among children in the United States, 2005–2006. Pediatrics, 122(6), 1149–1158.
Kolb, D. A. (1984). Experiential learning. Experience as the source of learning and development. Englewood Cliffs: Prentice Hall.
Kuiper, R. A., Murdock, N., & Grant, N. (2010). Thinking strategies of baccalaureate nursing students prompted by self-regulated learning strategies. Journal of Nursing Education, 49(8), 429–436.
Leslie, D. L., & Martin, A. (2007). Health care expenditures associated with autism spectrum disorders. Archives of Pediatric and Adolescent Medicine, 161(4), 350–355.
Liptak, G. S. (2006). Satisfaction with primary health care received by families of children with developmental disabilities. Journal of Pediatric Health Care, 20(4), 245–252.
Lisko, S. A., & O’Dell, V. (2010). Integration of theory and practice: Experiential theory and nursing education. Nursing Education Perspectives, 31(3), 106–108.
Long-Bellil, L. M., Robey, K. L., Graham, C. L., Minihan, P. M., Smeltzer, S. C., & Kahn, P., & Alliance for Disability in Health Care Education (2011). Teaching medical students about disability: The use of standardized patients. Academic Medicine, 86(9), 1163–1170.
Lotstein, D. S., Inkelas, M., Hays, R. D., Halfron, N., & Brook, R. (2008). Access to care for youth with special health care needs in the transition to adulthood. Journal of Adolescent Health, 43(1), 23–29.
Malow, B., Adkins, K. W., McGrew, S. G., Wang, L., Goldman, S. E., Fawkes, D., & Burnette, C. (2012). Melatonin for sleep in children with autism: A controlled clinical trial examining dose, tolerability and outcomes. Journal of Autism and Developmental Disorders, 42(8), 1729–1737. https://doi.org/10.1007/s00431-011-1669-1.
Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advanced Health Science Education, 14(4), 595–621.
Mazurek, M. O., Brown, R., Curran, A., & Sohl, K. (2016). ECHO autism: A new model. Pediatrics, 56(3), 247–256. https://doi.org/10.1177/0009922816648288.
Microsoft Corporation (2018). Description of the RAND function in Excel. n.d. Retrieved from https://support.microsoft.com/en- us/help/description-of-the-rand-function-in-excel.
Newacheck, P. W., & Kim, S. E. (2005). A national profile of health care utilization and expenditures for children with special health care needs. Archives of Pediatric and Adolescent Medicine, 159(1), 10–17.
Operation House Call: Families Teaching Health Professionals (2018). A program of the ARC of MA. Retrieved from http://www.operationhousecall.com.
Oswald, D. P., Gilles, D. L., Cannady, M. S., Wenzel, D. B., Willis, J. H., & Bordurtha, J. N. (2013). Youth with special healthcare needs: Transition to adult health care services. Maternal and Child Health, 17(10), 1744–1752.
Patel, M. S., & O’Hare, K. (2010). Residency training in transition of youth with childhood-onset chronic disease. Pediatrics, 126(Suppl 3), S190–S193.
Piven, J., & Lewis, J. (2011). Autism spectrum disorders in older adults: Toward defining a research agenda. Journal of the American Geriatrics Society, 59(11), 2151–2155.
Robb, M. (2012). Self-efficacy with application to nursing education: A concept analysis. Nursing Forum, 47(3), 166–172. https://doi.org/10.1111/j.1744-6198.2012.00267.x.
Sandelowski, M. (2000). Whatever happened to qualitative descriptions? Research in Nursing and Health, 23, 334–340.
Sanders, J. (2009). The use of reflection in medical education: AMEE Guide No. 44. Medical Teacher, 31, 685–695.
Sargeant, J. M., Mann, K. V., van der Vleuten, C. P., & Metsemakers, J. F. (2009). Reflection: A link between receiving and using assessment feedback. Advances in Health Science Education, 14(3), 399–410.
Scarpinato, N., Bradley, J., Kurbjun, K., Bateman, X., Holtzer, B., & Ely, B. (2010). Caring for the child with an ASD in the acute care setting. Journal for Specialists in Pediatric Nursing, 15(3), 244–254.
Smeltzer, S. C., Blunt, E., Marozsan, H., & Wetzel-Effinger, L. (2014). Inclusion of disability related content in nurse practitioner curricula. Journal of the American Association of Nurse Practitioners, 27(4), 213–221.
Souders, M. C. (2002). Caring for children and adolescents with autism who require challenging procedures. Pediatric Nursing, 28(6), 555–562.
Stata Corporation. (2017). Stata Statistical Software: Release 15. College Station: StataCorp LLC.
The WITH Foundation (2017) Formerly known as The Special Hope Foundation: Vision and Mission. Retrieved from http://www.withfoundation.org.
Voelker, R. (2002). Putting mental retardation and mental illness on health care professionals’ radar screen. Journal of the American Medical Association, 208(4), 433–435.
Warfield, M. E., & Gulley, S. (2006). Unmet need and problems accessing specialty medical and related services among children with special health care needs. Maternal and Child Health Journal, 10(2), 201–216.
Will, D., Barnfather, J., & Lesley, M. (2013). Self-perceived autism competency of primary care nurse practitioners. The Journal of Nurse Practitioners, 9(6), 350–355.
Yuker, H. E., Block, J. R., & Young, J. H. (1966). The measurement of attitudes towards Disabled persons [Monograph]. Retrieved from https://files.eric.ed.gov/fulltext/ED044853.pdf.
Acknowledgments
Special thanks to Elaine Gabovitch MPA, Katherine Murray BSN, and Thomas Maloney MSN whose contributions made this study possible. This study would not have been possible without the support from the Arc of MA Operation House Call program.
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This work was supported by WITH Foundation.
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DI conceived of the study, participated in study design development, implemented the intervention, and oversaw data collection. She also participated in data analysis and interpretation activities and took the lead in drafting and revising the manuscript. PR and SD assisted with the study design, data analysis and interpretation, and manuscript preparation and revision. SF assisted with participant recruitment, implementing the educational intervention, and manuscript preparation. MS assisted with implementing the educational intervention and manuscript preparation. CC developed the study design, participated in data analysis and interpretation activities, and assisted with drafting and revising the manuscript. All authors read and approved the final manuscript.
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Iannuzzi, D., Rissmiller, P., Duty, S.M. et al. Addressing a Gap in Healthcare Access for Transition-Age Youth with Autism: A Pilot Educational Intervention for Family Nurse Practitioner Students. J Autism Dev Disord 49, 1493–1504 (2019). https://doi.org/10.1007/s10803-018-3846-9
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DOI: https://doi.org/10.1007/s10803-018-3846-9