Context
The current study was part of an implementation evaluation of a RCT that took place in 11 urban primary care sites in 3 cities. Sites are described in detail in our previous publication [citation removed for masked review]. In short, primary care and developmental pediatrics clinics were all affiliated with academic medical centers in their geographic region. Although demographics varied by city, all sites served culturally and linguistically diverse, predominantly low-income populations. In the larger study from which participants from the current study were drawn, 339 parents or legal guardians with children between the ages of 15 and 27 months who were determined to be “at-risk” for ASD through screening in standard primary pediatric care were randomized to receive either a FN intervention or conventional care management control. Family navigators received training in topics such as ASD management, community resources, and motivational interviewing. Navigators met with families for a minimum of three standardized visits at critical timepoints in the diagnostic process. Beyond these visits, the intervention allowed for flexibility and tailoring to family preferences and needs. Families worked with the navigator or care manager until 100 days after receipt of a formal diagnostic evaluation. This study was approved by the hospital-based institutional review board. This paper follows the COREQ guidelines for qualitative research.