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Background
Autistic people1 experience more physical and mental health conditions than non-autistic people and premature mortality [1, 2, 3, 4–5]. Several studies have highlighted a range of barriers faced by autistic adults in accessing healthcare services, which likely contribute to difficulties in identifying and treating autistic adults’ health conditions [6]. These include problems with patient-provider communication [7], a lack of autism training among healthcare providers [8], sensory overload due to healthcare environments [9], cognitively inaccessible systems and services, and a lack of adequate support [10, 11]. Health checks identify some important conditions that affect health and wellbeing and are available to some groups of people in several countries. Regular health checks designed for autistic people, incorporating adjustments to healthcare practices, may help to overcome these barriers and reduce health inequalities for autistic people.
Annual health checks for people with intellectual disabilities2 were developed and evaluated in several Randomised Controlled Trials (RCTs) [12, 13], leading to arrangements being put in place for people with intellectual disabilities to receive an annual health check within primary healthcare services. Recent studies found that health checks for people with intellectual disabilities consistently identified unmet health needs, resulted in targeted actions to address those needs, and reduced mortality [12, 13, 14, 15–16]. However, these may not be available to or appropriate for autistic people who do not have an intellectual disability. The development and implementation of a health check specifically for autistic adults might bring similar benefits.
Approaches that are similar to a health check for autistic people have been developed in the US and Australia. AASPIRE (Academic-Autism Spectrum Partnership in Research and Education) developed the AASPIRE Healthcare toolkit [10] to support autistic people in accessing primary care and to support primary care health professionals (hereafter health professional) in meeting the health needs of autistic people. This includes the Autism Healthcare Accommodations Tool (AHAT), which creates a customised ‘accommodations report’ for individuals to share with their healthcare providers highlighting things that would make healthcare easier for the individual. Evaluation of the AHAT in the US found that it significantly reduced barriers to healthcare and increased ratings of patient-provider communication and patient healthcare self-efficacy [10]. In Australia, use of the AASPIRE Healthcare toolkit [10] was explored with six autistic adults who reported...