Maternal and Child Health Training Program

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Funded Projects

Grant Title: The LoneStar LEND Program

Project Director(s):

Pauline A Filipek, MD
University of Texas Health Science Center at Houston
7000 Fannin Street Suite 2353
Houston, TX  77030
Phone: (713) 500-3709
FAX: (713) 500-3706
Email: Pauline.A.Filipek@uth.tmc.edu

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Problem:

Texas ranks in the bottom quartile in most statistics about its provision of service to children with autistic spectrum and other neurodevelopmental disabilities (ASD/ND).

Goals and Objectives:

Goal 1: To educate 10 long-, >40 medium- and > 500 short-term trainees (LTT, MTT, STT)/ year in interdisciplinary care for children with ASD/ND. Objective 1: Recruit/ enroll 10 LTT, >40 MTT, >500 STT each year (7, 35, and 300 in Yr 1, 400 STT in Yr 2) Objective 2: Include recruitment outreach to under-represented groups and underserved populations such that a minimum of 20% of the LTT, MTT and STT reflect diverse backgrounds each year. Goal 2: To prepare future Leaders in the diagnosis/ treatment of ASD/ND. Objective 1: LTT will show growth in leadership competencies from admission to the LEND Program to exit by the MCH Leadership Skills Self-Assessment each year. Objective 2: The LoneStar LEND impact will be demonstrated, in part, by an increasing number of publications and presentations at professional meetings related to ASD/ND over Years 1-5. Objective 3: Within 5 years of completing LEND, at least 50% of LTT will demonstrate leadership in academic, clinical, public health, and/or public policy related to ASD/ ND. Goal 3: To increase the rate of accurate diagnosis of ASD/ NDs in Texas. Objective 1: LTT and MTT will demonstrate proficiency in screening/ diagnosis of ASD/NDs after completion of the Didactic Seminars, Clinical Practicums and Field Experiences. STT will improve skills in identification of risk for and diagnosis of ASD/ND, as measured by online pre-/post- tests required for CEUs. •Objective 2: LEND Clinical Practicum Sites in Years 1-5 will demonstrate an increased rate and accuracy of screening/ diagnosis activities for ASD as compared with prior 5 years. Goal 4: To empower families to be an active participant in their child's treatment plan. Objective 1: In addition to Core Faculty, family members will be an integral part of the LEND program, including the Advisory and Evaluation Committees, and Clinical Practicums, in increasing numbers over Years 1-5: by Year 5, >50% of Family participants will be from under-represented populations. Objective 2: In Clinical Practicum sites, family assessments of care as measured by ratings obtained on a modified HRSA National Survey of CSHCN will improve from Years 1-5. Goal 5: To improve ASD/ND service delivery and systems through collaborations with MCH organizations. Objective 1: Create an electronic version of LEND didactic Seminars (DLI) accessible throughout the state of Texas by the middle of Year 2. Objective 2: The DLI will specifically target facilities serving children who are under-diagnosed/underserved/ underinsured, with cultural or linguistic diversity, or who are homeless or in foster care in 75% of its electronic marketing each Year. Objective 3: LEND will work with other MCH organizations to identify service delivery issues and develop action plans during Year 1 to specifically address during Years 2-5.

Methodology:

The LoneStar LEND Program will annually recruit LTT, MTT, and STT. Faculty in 11 Core Disciplines plus additional disciplines (e.g., disability law, public health, transition care, Texas state agencies/ services, leadership and cultural competencies) will provide >300 hours of didactic Seminars. Clinical Practicums will provide extensive experience in all aspects of care for children with ASD/ND, predominantly in sites for under-represented and underserved populations. Additional education will include an annual Conference focusing on topics relating to MCH objectives in ASD/ND and a Science Fair for high school students interested in the Core Disciplines and ASD/ND. A Distance Learning Initiative (DLI) will be implemented in Y2 consisting of the didactic Seminars and pertinent clinical topics (e.g., the correct use of screening instruments), aiming to provide CEUs at no cost to TX residents. The LoneStar LEND Program goal is 550+ total trainees/year by Year 3.

Coordination:

The LoneStar LEND will work with Texas Health and Human Services Commission (HHSC) and other state and local agencies to extend the impact beyond Houston. We will collaborate with the Oklahoma LEND and the UT-Austin and Texas A&M UCEDDs. As a new program, we will accept all opportunities for collaborations with other LENDs, UCEDDs, etc.

Evaluation:

The process evaluation will measure the primary program inputs and work activities including: recruitment activities, participant characteristics and performance, and collaboration. The outcome evaluation will measure the effectiveness of the program using multiple methods including secondary data analysis and surveys.

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