A mixed-methods process evaluation of Family Navigation implementation for autism spectrum disorder

Area of Science:

• Health Services Research
• Implementation Science
• Autism Spectrum Disorder Care

Background:

• Family Navigation is increasingly recognized for improving care access for children with autism spectrum disorder (ASD).
• Limited data exist on the practical implementation challenges of Family Navigation programs.
• This study addresses the need for understanding potential failures in Family Navigation implementation.

Purpose of the Study:

• To identify potential failure modes in implementing Family Navigation for children with ASD.
• To analyze the risks associated with these implementation failures using Failure Modes and Effects Analysis (FMEA).
• To provide data to guide the successful implementation of Family Navigation services.

Main Methods:

• A mixed-methods approach was employed within a randomized controlled trial.
• Failure Modes and Effects Analysis (FMEA) methodology was used with 9 experts in ASD Family Navigation.
• Experts rated potential failures on likelihood of occurrence, detection, and severity to calculate risk priority numbers.

Main Results:

• Five high-priority failure areas were identified: community service setup, initial family meetings, training, fidelity monitoring, and attending appointments.
• Setting up community-based services had the highest risk profile.
• Failure to attend testing appointments was rated as the most severe potential failure, with reasons including family receptiveness and scheduling.

Conclusions:

• This FMEA identified critical areas for potential failure in Family Navigation implementation for children with ASD.
• Understanding these risks and developing mitigation strategies is essential for effective program delivery.
• The findings offer practical guidance for optimizing Family Navigation services to improve care access for families affected by ASD.