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Children with autism spectrum disorders and developmental disabilities (ASD/DD) face barriers to participation in health promotion programs due to the lack of available and/or
affordable programs and trained staff at recreation centers. Children with ASD/DD from Korean immigrant families are one of the most underserved minority groups due to language, racial/ethnic discrimination, and stigma and shame within their own ethnic community. However, little research is available on development, implementation, and evaluation of a culturally adapted community health promotion program for the population, who experience health inequities. The purpose of this study is to assess the feasibility, acceptability, and effectiveness of a pilot program for children with ASD/DD from Korean immigrant families and test the following hypotheses: (1) Children with ASD/DD who received the intervention would reduce their weight; (2) Children with ASD/DD who received the intervention would gain increased knowledge of nutrition; and (3) Children with ASD/DD who received the intervention would increase their physical activity involvement.
Methods
The pilot study used a quantitative, quasi-experimental design (one-group design with pre- and posttest), and recruited 15 children with ASD/DD, aged between 6 and 16, from Korean immigrant families and provided a 7-week health promotion intervention, including 30-minute nutrition education session and 45-minute physical activity session with two age groups weekly. The intervention started in October 2019 and ended in December 2019 at a community-based agency, providing a wide range of information, support, and assistance to Korean immigrant families. To examine the effectiveness of a pilot health promotion program, the data were analyzed using the SPSS v.25. Data analyses were performed using descriptive statistics and Wilcoxon signed-rank test in order to examine the changes in the outcomes. Additionally, observational data (i.e., video recordings) measuring changes in physical activity involvement before and after the intervention among children with ASD/DD have been analyzed.
Results
Each participant’s BMI, nutrition knowledge, and physical activity involvement have been compared before and after the intervention. First, there were no statistically significant differences in BMI before and after participating in the intervention. Second, there were statistically significant differences in nutrition knowledge before and after participating in nutrition education sessions among participants. The posttest (μ = 58.87, SD= 10.87) is statistically significantly higher than the pretest (μ = 31.60, SD= 20.65) and the mean increase of 27.27 was found to be a statistically significant (p = .003, α = .05). This also indicates an 86% increase in the mean nutrition knowledge among them after participating in the intervention. Finally, findings from observational data showed a pattern of increased engagement in physical activity, including stretching, conditioning, and basketball drills/games (e.g., dribbling, passing, & shooting).
Conclusions & Implications
The findings of the study suggest that the pilot program was feasible/acceptable, and effective in gaining nutrition knowledge and increasing physical involvement among participants. Given the fact that Asian immigrants are the fastest growing population and nearly three-quarters of them were born abroad, development, implementation, and evaluation of a community-based, culturally adapted health promotion program is urgently needed.