Form 4 STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTER

OMB Control Number 0915-0335

Expiration Date XX/XX/201X

ATTACHMENT G:

STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL

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SEMI–STRUCTURED INTERVIEW GUIDE

STATE IMPLEMENTATION GRANTEE PROJECT DIRECTORS

The purpose of this interview is to gather information about the activities that have taken place as part of your CAAI grant, and the progress that has been made thus far in meeting the goals and objectives of the Combating Autism Act Initiative. The information you provide during the interview will supplement the data we gather from other sources, such as your noncompeting continuation applications, and the annual performance measures that you report each year. These data are being collected on behalf of MCHB from all the State Implementation grantees to inform the evaluation of this grant program as well as the overall evaluation of the Combating Autism Act Initiative. The results will be presented in two separate reports. One report will focus exclusively on the State Implementation Grants program. The other report will focus on all grant programs that received funding under the Combating Autism Re-Authorization Act.

The interview should take no longer than one hour. With your permission, I’d like to record out conversation for transcription purposes.

Begin Recording: Do I have your permission to record this interview?

I’ll be asking you some questions pertaining to four main topic areas, which correspond with the legislative goals of the Combating Autism Re-authorization Act, and with MCHB’s goals for the Combating Autism Act Initiative. The specific legislative goals that we will cover include:

1. Increasing awareness of ASD and other DD

2. Reducing barriers to screening and diagnosis

3. Training professionals to use valid and reliable screening tools, to confirm or rule out an ASD diagnosis and to provide evidence-based intervention for children with a confirmed diagnosis

In addition to these topics, I would also like to talk about ways in which your grant is working to improve systems of care for ASD and other DD. Do you have any questions or comments before we begin?

Awareness Building

Interviewer: Begin by summarizing grantees’ reported activities related to awareness building.

Based on a review of your last noncompeting continuation application, I understand that your grant has been working to build awareness of ASD among (identify target populations) by (identify strategy, e.g., customizing and distributing LTSAE materials). Is that accurate?

• Please describe any collaborations that enabled you to extend the reach of your awareness building efforts.

  • Did you use or build on existing materials, for example, LTSAE materials?

• Did you work with other entities, like the Family to Family Health Information Centers?

• Can you tell me a bit about the communication strategies used (e.g., dissemination of print materials, webinars, PSAs)?

• Have any of your awareness building activities focused specifically on reducing disparities in screening rates, diagnostic referrals or early intervention services? Please explain.

• Have any of your efforts focused on raising awareness about family-centered medical homes for children with ASD/DD? If so, what audiences have you targeted?

• Have any of your efforts focused on raising awareness about transition services – either where families can find such services, or the need to develop more comprehensive transition services for young adults with ASD/DD?

• Please describe any efforts to measure changes in awareness among your target population(s).

• To what extent would you say your grant has successfully achieved what it set out to accomplish with respect to raising awareness of ASD and other DD?

  • Were there specific challenges that hindered your progress? What work remains to be done?

Training

Interviewer: Begin by summarizing grantees’ reported activities related to training. Include any types of training provided, e.g., providers, families, case managers, etc.

• From what I understand, your grant has focused on training (identify target audiences) to (identify goal of training initiatives). Would you say these were the primary training-related activities, or were there other activities I haven’t mentioned?

  • How did you identify this population as one in need of training?

  • What was the intended outcome or long term goal of your grant’s training efforts?

  • To what extent would you say the training initiatives have brought the State closer to that goal?

  • What metrics are you using to assess progress toward the goal?

• [If not already discussed]: How have you engaged families in your training efforts?

If there is a LEND in the State or in a neighboring State:

• Can you describe any efforts to collaborate with the LEND program in your (State/area) on training-related initiatives?

• How did your training efforts complement the training offered through LEND or other professional training programs?

• Can you describe any aspects of the training that focused on:

• Cultural competency?

• Coordination of care?

• Family-centered care?

Reducing Barriers

Another important objective specified in the authorizing legislation was to reduce barriers to early ASD screening and diagnosis. We recognize that there is overlap between this objective and the others, but for the purposes of this discussion, I’d like to focus on the specific barriers your grant aimed to address.

• What are the most significant service barriers in your State?

  • Which of those are being addressed through your grant?

  • What strategies are you using to address them?

Probe on following topics if grantee reported any of the following:

• Medical home initiatives

• Learning collaboratives

• Establishing patient registries

• Insurance coverage for services

• To what extent have your efforts in this area led to improved access to early screening, diagnostic and intervention services for ASD/other DD?

• What efforts, if any, are in place to track screening and referral rates?

• Is there any evidence of improved access to early screening and diagnostic services?

• What efforts have been made, or what efforts do you think are needed to ensure that any advances achieved during the grant period are sustained?

Improving systems of care

We understand that one of the primary objectives of the State Implementation Grants is to improve access to comprehensive, coordinated health care and related services for children and youth with ASD and other DD. MCHB has specified 6 specific components of comprehensive, coordinated care systems. Those components include:

1. Partnerships between professionals and families of children with ASD

2. Access to a culturally competent, family centered medical home

3. Access to adequate health insurance and financing of services

4. Early and continuous screening for ASD and other DD

5. Community services that are organized for easy use by families

6. Transition to adult care

• If not clear from the progress report: Which of these components has been the primary focus of your grant activities?

• What specific outcomes were you hoping to see as a result of those activities, and how would you know if those outcomes were accomplished?

Probes:

• What steps have been taken to ensure that children with ASD/DD and their families have access to a medical home?

• How has your grant addressed the need for community-based services that are organized for easy use by families?

• In what ways has your grant responded to the needs of young people with ASD/DD who are transitioning to adulthood?

• If information is available from progress reports: It appears that your grant has focused largely on (identify components addressed in plan and progress report). Would you say you have accomplished your objectives in this area, or that you are on track to accomplishing what you had hoped to accomplish? If so, how did you know your efforts were successful? If not, what barriers or challenges got in the way?

• Apart from the six components I referred to earlier, what other improvements you are working towards with respect to your State’s system of care for families who have a child with ASD?

AMCHP Technical Assistance

• We are also evaluating the contributions of AMPCHP under the CAAI. To assist in that evaluation, we would like to ask a few questions about your interactions with AMCHP.

• What kind of technical assistance has AMCHP provided to your program to support your activities under the CAAI?

• Can you provide any examples of the technical assistance offered? How was it provided?

• Are there any specific examples of how this TA helped you to meet your objectives?

• Are there any specific challenges that you were able to address with AMCHP’s support?

• In what ways has AMCHP facilitated collaboration between your team and other State grantees, as well as with other organizations and entities focused on children with ASD and other DD?

• Are you aware of any information resources produced and disseminated by AMCHP for grantees and national stakeholders, including families? If so, to what extent have you used these resources as part of your grant, and for what purposes?

Wrap-up

We are just about done. Before we end, however, I wanted to give you an opportunity to talk about any grant activities that we have not yet covered. Is there anything else you’d like to add, or any examples of ways in which your grant has helped to promote early identification of ASD and access to comprehensive, coordinated services?

• What would you say is/has been the single most important accomplishment of your grant?

• To what extent do you feel that the changes set in motion through your grant will be sustained following the end of the grant?

Thank you for your time. We greatly appreciate your assistance.