Autistic spectrum disorders in Brazilian primary care: Telehealth and face-to-face training method

Main Article Content

Rosane Lowenthal
Luciana Coltri Silva
Claudio Torres Miranda
Jorge Arthur Peçanha de Miranda Coelho
Cristiane Silvestre De Paula

Abstract

Primary care professionals are usually the first ones to detect symptomns of autism. We have developed and evaluated an educational model via a combined telehealth and face-to-face approach to handle autism spectrum disorders (ASD) and child mental health. The training comprised two modules involving distance-learning and face-to-face teaching environments. A total of 150 healthcare professionals – 75 doctors and 75 nurses – from five Brazilian cities were trained. Videos about ASD and child mental health were developed for the distance-learning module. The face-toface module was based on training regarding “Mental health communication skills for child and adolescent primary care.” The professionals were evaluated before and after training utilizing a specific knowledge questionnaire and surveys on Knowledge, Attitude, and Practice (KAP). Knowledge acquisition, practice, and attitude improved significantly after training (p < 0.01). Our results indicated that the use of interactive tele-education to train professionals in primary care is feasible and effective.

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Section
Desenvolvimento Humano - Seção Especial: Transtorno do Espectro Autista

References

Bellando, J., & Fussell, J. J. (2015). Autism speaks toolkits : Resources for busy physicians. Clinical Pediatrics, 55(2), 171–175. doi:10.1177/0009922815594587

Biel, M. G., Anthony, B. J., Mlynarski, L., Godoy, L., & Beers, L. S. (2017). Collaborative training efforts with pediatric providers in addressing mental health problems in primary care. Academic Psychiatry, 41(5), 610–616. doi:10.1007/s40596-017-0709-1

Bordini, D., Lowenthal, R., Gadelha, A., Araujo, G. M. Filho, Mari, J. D. J., & Paula, C. S. (2015). Impact of training in autism for primary care providers: A pilot study. Re-vista Brasileira de Psiquiatria (Sao Paulo, Brazil: 1999), 37(1), 63–66. doi:10.1590/ 1516-4446-2014-1367

Brasil. Lei no 8.080 de 19 de setembro de 1990. Sistema Único de Saúde. Diário Oficial da União, Brasília, DF. 20 de Setembro de 1990. Retrieved from http://conselho.saude.gov.br/legislacao/index.htm

Chambers, N. J., Vries, P. J. de, Delehanty, A. D., & Wetherby, A. M. (2018). Feasibility of Utilizing Autism Navigator ® for Primary Care in South Africa, 11, 1511–1521. doi:10.1002/aur.2018

Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchalli, S., Marcín, C., ... Fombonne, E. (2012). Global prevalence of autism and others pervasive developmental disorders. Autism Research, 5(3),160–179. doi:10.1002/aur.239

Fatori, D., Evans-Lacko, S., Bordin, I. A., & Paula, C. de. (2012). Correspondence Ways out of the crisis behind Bribegate for Child mental health care. The Lancet, 379(9812), e16–e17. doi:10.1016/S0140-6736(12)60105-6

Hepburn, S. L., Blakeley-Smith, A., Wolff, B., & Reaven, J. A. (2016). Telehealth delivery of cognitive-behavioral intervention to youth with autism spectrum disorder and anxiety: A pilot study, 20(2), 207–218. doi:10.1177/1362361315575164

Kobak, K. A., Leuchter, A., DeBrota, D., Engelhardt, N., Williams, J. B., Cook, I. A., ... Al-pert, J. (2010). Site versus centralized raters in a clinical depression trial: Impact on patient selection and placebo response. Journal of Clinical Psychopharmacology, 30(2),193–197. doi:10.1097/JCP.0b013e3181d20912

Lampert, S. S., Lamoglia, A., & Bosa, C. A. (2018). The Importance of evaluating training programs aimed at the identification of early markers of Autism Spectrum Disorder (ASD). Temas em Psicologia, 26, 1411–1425.

Lowenthal, R. (2014). Capacitação em Saúde Mental na Infância e na Adolescência para Pro-fissionais da Atenção Primária. São Paulo: Editora Meckenzie.

Mazurek, M. O., Brown, R., Curran, A., & Sohl, K. (2016). ECHO Autism : A new model for training primary care providers in best-practice care for children with autism. Cli-nical Pediatrics, 56(3), 247–256. doi:10.1177/0009922816648288

Paula, C. S. de, Duarte, C., & Bordini, I. (2007). Prevalence of mental health problems in children and adolescents from the outs-kirts of São Paulo City and estimation of services need and capacity. Revista Brasileira de Psiquiatria, 29, 11–27. doi:10.1590/S1516-44462006005000012

Paula, C. S., Lauridsen-Ribeiro, E., Wissow, L., Bordin, I. A. S., & Evans-Lacko, S. (2012). How to improve the mental health care of children and adolescents in Brazil: ac-tions needed in the public sector. Revista Brasileira de Psiquiatria (São Paulo, Brazil: 1999), 34(3), 334–351. doi:10.1016/j.rbp.2012.04.001

Paula, C. S., Nakamura, E., Wissow, L., Bordin, I. A., & Nascimento, R. (2009). Primary care and children’s mental health in Brazil. Mental Health and Child Development, 9(4), 249–255. doi:10.1016/j.acap.2009.02.006

Perou, R., Bitsko, R., Blumberg, S. J., Pastor, P., Ghandour, R. M., & Gfroerer, J. C. (2013). Mental health surveillance among children – United States, 2005-2011. MMWR Supplement, 17, 1–35.

Ribeiro, S. H., Paula, C. S. de, Bordini, D., Mari, J. J., & Caetano, S. C. (2017). Barriers to early identification of autism in Brazil. Revista Brasileira de Psiquiatria, 39, 352–354. doi:10.1590/1516-4446-2016-2141

Silva, L. C., Paula, C. S. D., Teixeira, M. C. T. V., & Lauridsen-Ribeiro, E. (2016). Impact of training program to treat children with autism in CAPSi units. Revista Brasileira de Psiquiatria, 40(3), 296–305. doi:10.1590/1516-4446-2016-2090

Wen, C. L. (2006). Telemedicina e Telessaúde – um panorama no Brasil. Atual Bras Telemed Telessaúde, 2, 3–5.

Wissow, L., Gadomski, A., Roter, D., Larson, S., Brown, J., Zachary, C., ... Wang, M.-C. (2008). Improving child and parent mental health in primary care: A cluster-ran-domized trial of communication skills training. Pediatrics, 121(2), 266–75. doi:10.1542/peds.2007-0418.

Zwaigenbaun, L., Bauman, M. L., Stone, W. L., Yirmiya, N., Estes, A., Hansen, R. L., ... Wetherby, A. (2015). Early identification of Autism Spectrum Disorder: Recommen-dations for practice and research. Pediatrics, 136(1), S60–S81. doi:10.1542/peds.2014-33667E