Using Causative Methods to Determine System-Level Factors Driving the Uptake and Use of Evidence-Based Practices in a Public Early Intervention System.

Part C Early Intervention (EI) systems are an entry point to services for autistic toddlers and can be leveraged to facilitate access to autism evidence-based practices (EBPs). However, EI systems are complex and limited research has examined how an EI system's infrastructure (i.e. system-level factors) impacts the adoption and implementation of EBPs. To address this gap, 36 EI providers and 9 EI administrators completed a semi-structured interview or focus group about factors impacting the implementation of autism EBPs. Qualitative analysis included a combination of grounded theory and causative coding. Analyses were refined by input from providers, administrators, and family stakeholders in the form of round tables and presentations at the state's interagency coordinating council. Primary themes centered on: (1) the costs associated with independent contracting structures; (2) operational demands; (3) workforce stability; (4) communication consistency; and (5) implementation supports for EBP implementation. Causative coding helped to demonstrate the perceived relationships between these factors and underscored the important role of incentivization structures, collaboration opportunities, and championing in supporting the use of EBPs within a system that primarily uses independent contracting structures. The current study extends previous research by demonstrating how several system-level factors are perceived to play a role in the adoption and implementation of EBPs by independently contracted EI providers. These findings underscore the need for implementation strategies, such as incentivization strategies and social network building, to increase providers' implementation of autism EBPs within EI systems.

Early Intervention Provider-Reported NDBI Use and Relationships with Provider- to System-Level Implementation Determinants.

An expanding evidence base has advocated for delivery of naturalistic developmental behavioral interventions (NDBIs) within community systems, thus extending the reach of these practices to young autistic children. The current study examined provider-reported use of NBDIs within a Part C Early Intervention (EI) system and the extent to which provider background, attitudes, and perceived organizational support predicted NDBI use. Results from 100 EI providers representing multiple disciplines indicated reported use of NDBI strategies within their practice despite inconsistent reported competency with manualized NDBI programs. Although NDBI strategy use was not predicted by provider experiences or perceived organizational support, provider openness to new interventions predicted the reported use of NDBI strategies. Future directions include mixed methods data collection across and within EI systems to better understand NDBI use and ultimately facilitate NDBI implementation.

Partnering With Latino/a Caregivers and Community Stakeholders to Understand Priorities and Needs Prior to Implementing an Early Literacy Program.

PURPOSE: Latino/a children disproportionately experience academic vulnerabilities, including in reading. Caregiver-mediated interventions can be leveraged to support the bilingual language development of young Latino/a children to prevent these well-documented disparities in reading. However, in leveraging these programs, it is important to weigh Latino cultural values surrounding education, family connection, and learning alongside the barriers and inequities experienced by Latino families. In response to this need, this study used a community-partnered approach to (a) understand caregivers' needs related to the language and literacy development of their young children and (b) understand perspectives for how best to implement a culturally adapted and culturally responsive caregiver-mediated program. METHOD: A total of 101 caregivers completed a needs assessment of sociodemographic information, child development and needs, and family needs. Subsequently, nonprofit staff and caregivers completed semistructured interviews or focus groups about the development and implementation of a birth-to-5 program supporting early language development. RESULTS: Thirty-five percent of families reported having at least one child with delayed language. Furthermore, 60.3% of respondents reported desiring strategies to support their child's early reading. Deductive content analysis revealed that both staff and caregivers desired a birth-to-5, caregiver-mediated program. Staff described family-level characteristics to consider for an early language program, community strengths, specific inequities faced by Latino families, and suggestions about culturally responsive early language and literacy program content and structure. Caregivers described barriers and inequities that they have faced related to their children's learning and development and how a birth-to-5 program could be responsive to their needs and values. CONCLUSIONS: Staff and caregiver emphasized the resilience of Latino families and their strong values surrounding educational involvement. At the same time, participants also reported barriers and inequities rooted in systemic racism that have prevented families from being involved in certain aspects of the children's education. Together, these results revealed the importance of an early literacy program that is responsive to the structural inequities experienced by families.