Presenter Status
Resident/Psychology Intern
Abstract Type
Research
Primary Mentor
Dr. Laura Plencner
Start Date
9-5-2023 11:30 AM
End Date
9-5-2023 1:30 PM
Presentation Type
Abstract
Description
Background: Adverse childhood experiences (ACEs) impact a majority of individuals, with approximately two-thirds of adults having experienced 1 or more ACE.1 The health consequences of ACEs are significant, including cardiovascular disease, cancer, autoimmune diseases, and mental illnesses.1 These health impacts can even start as early as childhood, leading to an increased risk of learning and behavioral concerns.2,3 Recent evidence has also identified the impact that parental ACEs may have on parenting and child development,4,5,6 which in turn may lead to an intergenerational transmission of ACEs.4,7 As a nurturing caregiver relationship is key for buffering adversity,2,8 it is imperative to address ACEs within families in order to limit the health consequences both for parents and children. The AAP has tasked pediatricians with the incredibly important feat of addressing ACEs in clinical practice.9 Parental ACE screening may provide an approach to mitigating ACEs in children by supporting the whole family.7,8
Objectives/Goal: The primary objective is to implement parental ACEs screening within University Health Internal Medicine-Pediatrics clinic in order to identify families experiencing or at risk for adversity and provide parental support through trauma-informed care, education, and a community support network to mitigate the impacts of ACEs on families. Developing support for families impacted by ACEs requires a multifaceted, trauma-informed approach with community involvement. We aim to build a support network by partnering with community organizations dedicated to caring for families impacted by trauma such as in-home visiting services, parents as teachers, and family mental health services. In addition, we aim to obtain feedback from parents to help guide this process and the specific supports needed by our clinic families. Together, we aim to use a quality improvement focus, guided by community partners and families, to determine how to best mitigate the impact of ACEs in our patients.
Methods/Design: A pilot protocol for parental ACEs screening within University Health Internal Medicine-Pediatrics Clinic was used to initiate ACEs screening for our pediatric families. Parents with infants aged 6-9 months were screened for ACEs at their child’s well visit. Parents completed a de-identified parental ACEs questionnaire to assess for parental adverse childhood experiences. Screening was used to identify families impacted by ACEs, provide universal ACEs education for families, provide additional resources regarding ACEs, and connect families to community partners for additional support as needed. Previous research has demonstrated that resources needed by parents to respond to ACEs primarily include education and parenting support. 7,10,11 Therefore, connections were made with community organizations that provide these services to connect families to additional support where needed. To assess the feasibility of implementing ACEs screening in this clinical setting, chart review was used to monitor screening completion rates and barriers to screening. Survey was created to assess parent comfort with ACEs screening process and provide feedback on needed resources or support.
Results: Preliminary results demonstrate that parental ACEs screening was completed for approximately 40-50% of families at 6-9 month well visits completed thus far since screening implementation. Parent feedback surveys on ACEs screening process have been initiated. Further data on parental ACEs scores, barriers to screening, and parental feedback is currently being collected.
Conclusions: With the goal of mitigating the impact of ACEs on families, parental ACEs screening was implemented in an Internal Medicine-Pediatrics Clinic to identify families experiencing or at risk for adversity and provide support to families through trauma-informed care, education, and community support. A pilot protocol was used to initiate parental ACEs screening in order to assess the feasibility and benefit of ACEs screening for our pediatric families. Parent feedback was used to assess the value and limitations of ACEs screening, education, resources, and supportive community organizations for our pediatric families. With the goal of expanding ACEs screening to all pediatric patients and families in our clinic, the results of this study will be used to optimize our ability to support families impacted by adverse childhood experiences and ultimately prevent future ACEs.
MeSH Keywords
adverse childhood experiences; screening; parents
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Supporting Families Impacted by Adverse Childhood Experiences (ACEs)
Background: Adverse childhood experiences (ACEs) impact a majority of individuals, with approximately two-thirds of adults having experienced 1 or more ACE.1 The health consequences of ACEs are significant, including cardiovascular disease, cancer, autoimmune diseases, and mental illnesses.1 These health impacts can even start as early as childhood, leading to an increased risk of learning and behavioral concerns.2,3 Recent evidence has also identified the impact that parental ACEs may have on parenting and child development,4,5,6 which in turn may lead to an intergenerational transmission of ACEs.4,7 As a nurturing caregiver relationship is key for buffering adversity,2,8 it is imperative to address ACEs within families in order to limit the health consequences both for parents and children. The AAP has tasked pediatricians with the incredibly important feat of addressing ACEs in clinical practice.9 Parental ACE screening may provide an approach to mitigating ACEs in children by supporting the whole family.7,8
Objectives/Goal: The primary objective is to implement parental ACEs screening within University Health Internal Medicine-Pediatrics clinic in order to identify families experiencing or at risk for adversity and provide parental support through trauma-informed care, education, and a community support network to mitigate the impacts of ACEs on families. Developing support for families impacted by ACEs requires a multifaceted, trauma-informed approach with community involvement. We aim to build a support network by partnering with community organizations dedicated to caring for families impacted by trauma such as in-home visiting services, parents as teachers, and family mental health services. In addition, we aim to obtain feedback from parents to help guide this process and the specific supports needed by our clinic families. Together, we aim to use a quality improvement focus, guided by community partners and families, to determine how to best mitigate the impact of ACEs in our patients.
Methods/Design: A pilot protocol for parental ACEs screening within University Health Internal Medicine-Pediatrics Clinic was used to initiate ACEs screening for our pediatric families. Parents with infants aged 6-9 months were screened for ACEs at their child’s well visit. Parents completed a de-identified parental ACEs questionnaire to assess for parental adverse childhood experiences. Screening was used to identify families impacted by ACEs, provide universal ACEs education for families, provide additional resources regarding ACEs, and connect families to community partners for additional support as needed. Previous research has demonstrated that resources needed by parents to respond to ACEs primarily include education and parenting support. 7,10,11 Therefore, connections were made with community organizations that provide these services to connect families to additional support where needed. To assess the feasibility of implementing ACEs screening in this clinical setting, chart review was used to monitor screening completion rates and barriers to screening. Survey was created to assess parent comfort with ACEs screening process and provide feedback on needed resources or support.
Results: Preliminary results demonstrate that parental ACEs screening was completed for approximately 40-50% of families at 6-9 month well visits completed thus far since screening implementation. Parent feedback surveys on ACEs screening process have been initiated. Further data on parental ACEs scores, barriers to screening, and parental feedback is currently being collected.
Conclusions: With the goal of mitigating the impact of ACEs on families, parental ACEs screening was implemented in an Internal Medicine-Pediatrics Clinic to identify families experiencing or at risk for adversity and provide support to families through trauma-informed care, education, and community support. A pilot protocol was used to initiate parental ACEs screening in order to assess the feasibility and benefit of ACEs screening for our pediatric families. Parent feedback was used to assess the value and limitations of ACEs screening, education, resources, and supportive community organizations for our pediatric families. With the goal of expanding ACEs screening to all pediatric patients and families in our clinic, the results of this study will be used to optimize our ability to support families impacted by adverse childhood experiences and ultimately prevent future ACEs.
