1 - (SYM 47) A Scoping Review of Approaches to Adapt Mental and Behavioral Health Evidence-based Practices (EBPs) for Autistic Youth in Community-based Settings

Background: Mental and behavioral health evidence-based practices (EBPs) for autistic youth are commonly adapted for use in community-based settings with the utilization of community-engaged research methods (Stahmer et al., 2005). It is unknown which adaptation method, including what level of community engagement, is most effective and feasible for enhancing fit of mental and behavioral health EBPs with autistic client needs in a community service context and improving implementation and intervention outcomes (Dickson et al., 2021). 

Methods: Using the Model for Adaptation Design and Impact (MADI) and The Continuum of Community Engagement in research, this scoping review aimed to assess current literature on approaches to adapt mental and behavioral health EBPs for autistic youth served in community-based settings (Key et al., 2019; Kirk et al., 2020). A total of 349 articles were identified and 37 of these articles were included in the final review. Frequencies were obtained for MADI and The Continuum of Community Engagement in research domains reported and assessed across studies. Qualitative content analysis was used to yield more nuanced descriptions of each adaptation approach and related feasibility and empirical support (Graneheim & Lundman, 2004). 

Results: Reasons for continual adaptation, common factors for improved feasibility and effectiveness, and two exemplar methods were identified. Reasons for continual adaptation were differences between research laboratories and community-based settings, prohibitive characteristics of EBPs (e.g., complexity, length, training structure), and lack of consideration of client priorities and characteristics. Common factors for improved feasibility and effectiveness included defining core mechanisms of change, using systematic adaptation processes, carefully considering outcomes, and using community engaged methods. Two approaches embodying each of these common factors were use of the Medical Research Council Framework (Divan et al., 2015) and an adapted version of the Method for Adaptation through Community Engagement (Yingling et al., 2020). 

Conclusion: This scoping review contributes to science found at the intersection of autism research, implementation science, and community-engaged research. It has the potential to inform and improve efforts to implement EBPs in community-based settings and consequently improve wellbeing among autistic youth and their families.