Family Navigation Engagement and Outcomes for Children With a New Autism Diagnosis

Family navigation (FN) is a promising intervention for reducing barriers and addressing inequities in healthcare, but engaging families in FN can be challenging. This study assessed FN engagement for historically underserved families of children newly diagnosed with autism. Objectives were to (1) describe FN engagement rates across four stages: recruitment, enrollment, retention, and involvement; (2) examine family characteristics influencing recruitment, enrollment, and retention; and (3) evaluate the receipt of autism-specific services based on family characteristics and number of interactions with navigators.

This descriptive cohort study included families who were Medicaid recipients or self-identified as Hispanic/Latino or Black/African-American. Spanish-English bilingual, bicultural navigators provided FN through semi-structured sessions and brief contacts with participants. Descriptive statistics analyzed family demographics and engagement rates. Regression analyses examined family characteristics predictive of successful engagement and service receipt.

Of 292 eligible families, 210 (71.9%) were recruited, 155 of whom (73.8%) enrolled. Caregivers preferring a language besides English (85% of whom preferred Spanish) were five times more likely to enroll (OR = 5.15) and participated in significantly more interactions with navigators. Each additional FN session and contact increased the probability of obtaining autism-specific services by 61% and 17%, respectively.

About half of eligible families enrolled in this FN program. Families preferring a language besides English had higher engagement rates at multiple stages. Brief contacts complemented semi-structured sessions, each contributing to an increased likelihood of children receiving autism-specific services. Once families enroll, FN may increase service access for historically underserved families.