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      Helping Optimize Language Acquisition (HOLA) Online Parent Training Modules for Latinx Parents of Toddlers at Risk for ASD: Protocol for a Pilot Funded by the Organization for Autism Research

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          Abstract

          Background

          Culturally competent parent training in evidence-based intervention for autism spectrum disorder (ASD) can provide young Latinx children from underserved communities with early interventional support while they wait for professional services, thus reducing the impact of intervention delays. Providing parents with brief bilingual training in Pivotal Response Treatment (PRT) is a strategy that can overcome these barriers and is inexpensive to disseminate. Brief PRT training has been shown to significantly improve joint attention, expressive language, responsivity, and adaptive skills in young children with ASD. However, it is unknown whether an interactive, culturally competent online parent training in PRT is effective in a Latinx population.

          Objective

          To this end, we will recruit 24 children (16-36 months old) at risk for ASD and their parent(s) from East and South Los Angeles and provide them with a series of 6 online learning modules in their choice of Spanish or English.

          Methods

          This pilot study will utilize a single-group, pilot, pre-post design with follow-up assessments 6 weeks later. Linear mixed-effects model analysis will be used to explore most parent-reported and coded outcomes.

          Results

          Brief online parent training in evidence-based treatments has the capacity to increase access to culturally competent early communication interventions for young children at risk for ASD.

          Conclusions

          The results of this trial may have particular salience in additional underresourced communities where children have limited access to interventions prior to entering school.

          International Registered Report Identifier (IRRID)

          PRR1-10.2196/18004

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          Most cited references34

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          Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

          Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships.
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            Instructional design variations in internet-based learning for health professions education: a systematic review and meta-analysis.

            A recent systematic review (2008) described the effectiveness of Internet-based learning (IBL) in health professions education. A comprehensive synthesis of research investigating how to improve IBL is needed. This systematic review sought to provide such a synthesis. The authors searched MEDLINE, CINAHL, EMBASE, Web of Science, Scopus, ERIC, TimeLit, and the University of Toronto Research and Development Resource Base for articles published from 1990 through November 2008. They included all studies quantifying the effect of IBL compared with another Internet-based or computer-assisted instructional intervention on practicing and student physicians, nurses, pharmacists, dentists, and other health professionals. Reviewers working independently and in duplicate abstracted information, coded study quality, and grouped studies according to inductively identified themes. From 2,705 articles, the authors identified 51 eligible studies, including 30 randomized trials. The pooled effect size (ES) for learning outcomes in 15 studies investigating high versus low interactivity was 0.27 (95% confidence interval, 0.08-0.46; P = .006). Also associated with higher learning were practice exercises (ES 0.40 [0.08-0.71; P = .01]; 10 studies), feedback (ES 0.68 [0.01-1.35; P = .047]; 2 studies), and repetition of study material (ES 0.19 [0.09-0.30; P or=89%) in most analyses. Meta-analyses for other themes generally yielded imprecise results. Interactivity, practice exercises, repetition, and feedback seem to be associated with improved learning outcomes, although inconsistency across studies tempers conclusions. Evidence for other instructional variations remains inconclusive.
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              mHealth Technology Use and Implications in Historically Underserved and Minority Populations in the United States: Systematic Literature Review

              Background The proportion of people in the United States who are members of at least two ethnic groups is projected to increase to 10% by the year 2050. This makes addressing health disparities and health inequities in minority populations increasingly more difficult. Minority populations, including those who classify themselves as African American and Hispanic, are using mobile phones to access health information via the internet more frequently than those who classify themselves as white, providing unique opportunities for those in public health and health education to reach these traditionally underserved populations using mobile health (mHealth) interventions. Objective The objective of this review was to assess studies conducted in the United States that have used mHealth tools and strategies to develop and implement interventions in underserved populations. This review also examines the ways in which mHealth strategies are being employed in public health interventions to these priority population groups, as mobile phone capabilities include text messaging, mobile apps, internet access, emails, video streaming, social media, instant messaging, and more. Methods A systematic literature review was conducted using key search phrases, the matrix method, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart diagram to identify key studies conducted between the years of 2009-2016 in the United States. These studies were reviewed for their use of mHealth interventions in historically underserved and minority populations. Results A total of 16,270 articles were initially identified using key search phrases in three databases. Titles were reviewed and articles not meeting criteria were excluded, leaving 156 articles for further review. After additional review for relevance and inclusion criteria, 16 articles were qualified and analyzed. Conclusions mHealth is a promising area of development for public health and health education. While successful research has been done using text messaging (short message service, SMS) and other mHealth strategies, there is a need for more research using mobile phones and tablet applications. This literature review demonstrates mHealth technology has the ability to increase prevention and health education in health disparate communities and concludes that more specified research is needed.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                December 2020
                10 December 2020
                : 9
                : 12
                : e18004
                Affiliations
                [1 ] California State University Los Angeles, CA United States
                Author notes
                Corresponding Author: Robin Lynn Dodds rdodds@ 123456calstatela.edu
                Author information
                https://orcid.org/0000-0001-7748-0426
                Article
                v9i12e18004
                10.2196/18004
                7759438
                33300494
                45766234-19c5-41eb-a577-71fe5a96a073
                ©Robin Lynn Dodds. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 10.12.2020.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 28 January 2020
                : 12 June 2020
                : 13 October 2020
                : 17 November 2020
                Categories
                Protocol
                Protocol

                autism spectrum disorders,cultural diversity,parent training,pivotal response treatment,health disparities,online training,autism,intervention delay,online learning,pediatrics

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