Using normalization process theory to inform practice: evaluation of a virtual autism training for clinicians

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O’Hagan, B., Augustyn, M., Amgott, R., White, J. L., Hardesty, I., Bangham, C., Ursitti, A., Foster, S., Chandler, A., & Greece, J. (2023). Using normalization process theory to inform practice: evaluation of a virtual autism training for clinicians. Frontiers in Health Services, 3, 1242908-1242908. https://doi.org/10.3389/frhs.2023.1242908

Journal or book title
Frontiers in Health Services
Publisher
Frontiers Media SA
Volume
3
Pages
1242908-1242908
Article number
1242908
Publication date: 19 Dec 2023 Added to AutiHub: 5 Jul 2026 Type: Article Article language: English
Publisher source (DOI) Full text OpenAlex source

This publication is integrated into AutiHub through:

Authors

Publication authors
10
Publication authors identified as autistic
1 / 10 (10.0%)
  1. Belinda O’Hagan
  2. Marilyn Augustyn
  3. Rachel Amgott
  4. Julie L. White
  5. Ilana Hardesty
  1. Candice Bangham
  2. A. Ursitti
  3. Sarah Foster *
  4. Alana Chandler
  5. Jacey Greece

Abstract

Background: There is growing demand for developmental and behavioral pediatric services including autism evaluation and care management. Clinician trainings have been found to result in an increase of knowledge and attitudes. This study utilizes Normalization Process theory (NPT) to evaluate a clinician training program and its effects on practice. Methods: The year-long virtual training program about autism screening and care management included didactic portions and case presentations. Focus groups and interviews were conducted with primary care clinicians (n = 10) from community health centers (n = 6) across an urban area five months post-training. Transcripts were deductively coded using NPT to uncover barriers to implementation of autism screening and care, benefits of the training program, and areas for future training. Results: Participants were motivated by the benefits of expanding and improving support for autistic patients but noted this effort requires effective collaboration within a complex network of care providers including clinicians, insurance agencies, and therapy providers. Although there were support that participants could provide to families there were still barriers including availability of behavior therapy and insufficient staffing. Overall, participants positively viewed the training and reported implementing new strategies into practice. Conclusion: Despite the small sample size, application of NPT allowed for assessment of both training delivery and implementation of strategies, and identification of recommendations for future training and practice sustainability. Follow-up focus groups explored participants' practice five months post-program. Variations in participants' baseline experience and context at follow-up to enable application of skills should be considered when using NPT to evaluate clinician trainings.

Bibliography cited by this reference

Cited references are imported from external metadata sources when they are available. The list may be partial.

Cited bibliography overview

These indicators describe the bibliography cited by this publication. An author name is counted each time it appears in one cited reference, so the same person can be counted more than once. Names not yet linked to an author already present in AutiHub are treated as unknown, not as non-autistic. Last computed: 3 Oct 2026 01:00.

Cited references
41
With a DOI
39
Without a DOI, from raw bibliography text
2
4 / 41 (9.8%) cited references include at least one author identified as autistic.
References with data to complete
1 / 41 (2.4%)
References with detected author names
40 / 41 (97.6%)
Without detected author names
1
Without a structured title
1
Without a stable identifier
2
References with raw author names still to review
0
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
248
From DOI or external metadata
248
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
0
73 / 248 (29.4%) names are linked to an author already present in AutiHub. 175 / 248 (70.6%) names are not yet linked.
Names linked to a person identified as autistic
5 / 248 (2.0%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 5 / 73 (6.8%). Distinct people identified as autistic: 4 / 225 (1.8%).
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