Symposia
Autism Spectrum and Developmental Disorders
Kevin G. Stephenson, Ph.D.
Nationwide Children's Hospital
Reynoldsburg, Ohio
Charles Albright, PhD
Neurodevelopmental Psychologist
Nationwide Children's Hospital
Westerville, Ohio
Barbara Mackinaw-Koons, PhD
Neurodevelopmental Psychologist
Nationwide Children's Hospital
Westerville, Ohio
Amy Hess, BS
Behavioral Health Outreach Supervisor
Nationwide Children's Hospital
Westerville, Ohio
Sabrina Long, LISW-S
Clinical Social Worker
Nationwide Children's Hospital
Westerville, Ohio
Eric M. Butter, Ph.D.
Chief of Psychology; Director of Behavioral Health; Associate Professor, Pediatrics
Nationwide Childrens Hospital
Columbus, Ohio
Although evidence-based interventions for disruptive behaviors in autism spectrum disorders exist, more work is needed to disseminate knowledge and training to a wider range of behavioral health professionals. Innovative dissemination models, including the Extension for Community Healthcare Outcomes (ECHO; Komaromy et al., 2018), are a promising avenue to improve access to care. The ECHO model is a distance education paradigm using teleconferencing, case-based learning, and mentoring from experts in a given field and has been successfully used to disseminate best-practice care in autism to primary care providers (Mazurek et al., 2017). The model consists of a team of experts (Hub) that disseminates knowledge to participants (Spokes). We present evidence of the feasibility and preliminary outcomes of an adaptation of the ECHO model for the dissemination of the RUBI parent training program (ECHO RUBI) to behavioral health providers. The program consisted of 12 bi-weekly sessions. Each session included a didactic presentation on RUBI content by an expert Hub member followed by a case presentation by one of the Spokes with subsequent discussion and recommendations. To date, we have completed trainings with six cohorts between 2019 and 2021. Over 100 individuals from four countries in North and South America and Europe participated. Represented disciplines included licensed counselors, clinical social workers, psychologists, behavior analysts, medical providers, and parent partners. We also created a 17-item measure of provider self-efficacy (PSE) used in conjunction with the ECHO RUBI training. Overall satisfaction with the ECHO RUBI program was good (86%). Exploratory factor analysis of the PSE items revealed 3 factors (Understanding of Behavioral Principles; Confidence in Teaching Behavior Principles; Common Factors/Parent Engagement Skills). Internal consistency of the Total score and the three factor scores was strong (McDonald’s ωt = 0.92 – 0.98). We used paired-sample T-Tests to analyze Pre-Post PSE data from n = 63 ECHO RUBI participants. Overall provider self-efficacy significantly increased at post-assessment [t(62) = 6.14, p < .001, d = .77]. Overall, the ECHO RUBI program resulted in high satisfaction and showed evidence of increasing provider self-efficacy. The program shows potential as an efficient way to disseminate knowledge of evidence-based care to providers. Future research investigating the impact of ECHO RUBI in changing provider practice patterns and patient-level impact is needed.