Evaluation of a promotora-led intervention to build awareness of developmental milestones and warning signs of autism among families in South Texas

A March 2013 report from the Centers for Disease Control and Prevention shows that the prevalence of Autism Spectrum Disorders (ASDs) in children has increased from 1 in 88 to 1 in 50. Studies show that Hispanic children are usually diagnosed 2.5 years later with more advanced symptoms at time of diagnosis when compared to non-Hispanic children.  As such, there is a need for greater awareness about development milestones and ASDs among Hispanic families.  Promotoras (lay health workers) are well positioned within their communities to address this need and should be equipped with quality resources for public health outreach. One available resource is a bilingual promotora training curriculum developed by the Organization for Autism Research. We piloted this curriculum among 58 South Texas promotoras.  Successively, ten of these promotoras were given additional educational materials to raise awareness among a designated number of Hispanic families.  We then conducted 4 focus groups to discuss promotora experiences with the learning and teaching of the curriculum for evaluation purposes. Feedback from the focus groups provided insight that the training was useful, easy to understand, interactive, and relevant to the current needs of the Hispanic community. The promotoras emphasized that the curriculum was culturally sensitive and appropriate for families with limited health literacy. Overall, the outreach resulted in parent recognition of developmental milestones and delays that stimulated conversations with family members and physicians. With these encouraging results and further evaluation, the curriculum can be recommended for use by other community health workers.