“From the autistic human books’ stories, I understand their mindset and thoughts”: Pilot development and participatory realist evaluation of Human Library to enhance public understanding of autism

Unlike traditional autism awareness programs that often rely on didactic teaching and factual information, Human Library is a contact-based intervention that can engage "readers" in critical dialogs with "human books" to learn about their lived experience. This study reported on the pilot development of a Human Library in collaboration with a team of human books who are autistic to promote public understanding of autism in Hong Kong. Using a participatory realist evaluation framework, we conducted surveys and interviews with readers to construct a Human Library program model and evaluate its associated outcomes. Pre- and post-Human Library surveys showed a significant decrease in autism stigma and increase in neurodiversity attitudes. Interview findings revealed that readers' interests and concerns about the autistic community motivated them to participate in Human Library. Through personal interaction with autistic human books in a safe space created within Human Library, readers developed renewed understanding of autism and insights into autistic strengths. Readers became more informed of autistic people's perspectives and various sociocultural barriers that impact their well-being, which shaped how they would interact with autistic people in the community. The Human Library model has implications for promoting better understanding and attitudes of autism and fostering positive interaction between autistic and non-autistic people.Lay AbstractThere is a need to promote autism awareness and understanding in the public. Traditional methods often include direct teaching and sharing of facts about autism, but more creative and effective approaches are needed. Human Library (HL) works like an actual library, except that "books" are human beings who can share their lives and stories. This study developed and evaluated a Human Library specifically with autistic books to promote public understanding of autism in Hong Kong. We conducted surveys and interviews with the participating readers to understand how the Human Library works and its effects. After Human Library, readers reported decreased autism stigma and increased neurodiversity attitudes. Readers showed different understanding of autism contrary to their previous impressions. They appreciated more the strengths and perspectives of autistic individuals. They also considered more the autistic perspective when interacting with autistic people. Human Library can be an effective program to promote better understanding and attitudes of autism in the public.