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. 2020 Jun;8(2):176-188.
doi: 10.1037/cpp0000320.

Promoting Equity and Resilience: Wellness Navigators' Role in Addressing Adverse Childhood Experiences

Miya L Barnett  1 , Maryam Kia-Keating  1 , Andria Ruth  2 , Mayra Garcia  2
Affiliations

Promoting Equity and Resilience: Wellness Navigators' Role in Addressing Adverse Childhood Experiences

Miya L Barnett et al. Clin Pract Pediatr Psychol. 2020 Jun.

Abstract

Objective: Adverse childhood experiences (ACEs) have demonstrable negative effects on long-term physical and mental health. Racial and ethnic minority children disproportionally experience ACEs due to the impacts of structural inequality and discrimination, which could drive health disparities. Pediatric settings offer an opportune context to address ACEs and improve health equity, and to link families to the necessary resources to promote resilience. Wellness navigators (WNs), who can reflect patients' cultural, linguistic, and other shared characteristics, have the potential to improve patient care and integrated behavioral health services to mitigate the public health impact of ACEs. In the current study, bilingual and bicultural WNs helped to deliver an ACEs screening and response to predominately Latinx patients in a pediatric service setting.

Methods: Quantitative data on referrals made by WNs and qualitative interviews were analyzed to understand the role of WNs in ACEs screening.

Results: Among families (infants and caregivers) that screened positive for ACEs, WNs addressed social determinants of health and, based on individual needs assessments, made referrals to community resources in over half of the cases. Insurance, childcare, and housing were the most frequent referral sources. WNs supported caregivers in initiating services with 94% of the referrals that were made. Qualitative interviews with medical providers and caregivers underscored WNs' role in the ACEs screening process. Implications for ACEs screening, trauma-responsive pediatric care, and integrating WNs into an integrated behavioral health team are discussed.

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References

    1. American Academy of Pediatrics (AAP; 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
    1. Alegría M, Green JG, McLaughlin KA, & Loder S (2015). Disparities in child and adolescent mental health and mental health services in the US. New York: William T. Grant Foundation.
    1. Ali-Faisal SF, Colella TJF, Medina-Jaudes N, & Benz Scott L (2017). The effectiveness of patient navigation to improve healthcare utilization outcomes: A meta-analysis of randomized controlled trials. Patient Education and Counseling, 100(3), 436–448. - PubMed
    1. Averill JB (2002). Matrix Analysis as a Complementary Analytic Strategy in Qualitative Inquiry. Qualitative Health Research, 12(6), 855–866. - PubMed
    1. Barnett ML, Lau AS, & Miranda J (2018). Lay health worker involvement in evidence-based treatment delivery: A conceptual model to address disparities in care. Annual Review of Clinical Psychology, 14(1), 185–208. - PMC - PubMed