Trauma-Responsive Care in a Pediatric Setting: Feasibility and Acceptability of Screening for Adverse Childhood Experiences
- PMID: 31373039
- PMCID: PMC6917888
- DOI: 10.1002/ajcp.12366
Trauma-Responsive Care in a Pediatric Setting: Feasibility and Acceptability of Screening for Adverse Childhood Experiences
Abstract
Adverse childhood experiences (ACEs) have demonstrable negative effects on long-term physical and mental health. Low-income and ethnic minority communities face significant disparities in exposure to ACEs. Pediatric settings offer an opportune context to identify and address ACEs, with the potential to reduce barriers in access to resources and services. The current study examined the feasibility and acceptability of screening infants and their parents for ACEs at a community medical clinic. Feasibility data indicated that 151 (92%) of the 164 unique patients that presented for well-child visits for infants (4- to 12-months) across a 13-month period were screened for infant and parent ACEs. Of these 151 patients, 47% met eligibility (infants with 1 + ACEs, parents with 2 + ACEs) deemed intermediate risk and indicated referral to prevention services. The majority of referred families (77%) accepted prevention services, including appointments with bilingual and bicultural wellness navigators who provided a cultural bridge and access to resources that could address patients' social determinants of health. Qualitative interviews with providers expand upon screening acceptability. Implications for integrated behavioral health, ACEs screening, and trauma-responsive prevention in a pediatric setting are discussed.
Keywords: Adverse childhood experiences; Integrated behavioral health; Pediatric; Prevention; Screening; Trauma-responsive.
© 2019 Society for Community Research and Action.
Conflict of interest statement
Conflicts of Interest: The authors have no conflicts to report.
References
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- American Academy of Pediatrics. (2014). Addressing adverse childhood experiences and other types of trauma in the primary care setting. Retrieved from https://www.aap.org/en-us/Documents/ttb_addressing_aces.pdf
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- Cottage Health, Priory Fund/International
- Outhwaite Foundation/International
- James S. Bower Foundation/International
- R25 MH080916/MH/NIMH NIH HHS/United States
- University of California, Santa Barbara (UCSB) Academic Senate/International
- First 5 Santa Barbara County/International
- R13 HD075495/HD/NICHD NIH HHS/United States
- Health Resources & Services Administration/International
- R03 HD089465/HD/NICHD NIH HHS/United States
- Center for Youth Wellness National Pediatric Practice Community/International
- Mosher Foundation/International
- Towbes Foundation/International
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