Sabrina R Liu, Katherine E Grimes, Timothy B Creedon, Priya R Pathak, Lindsay A DiBona, Gregory N Hagan
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Using mixed methods, we explored the feasibility, acceptability, and utility of conducting ACEs routine inquiry with an ethnically and economically diverse pediatric population through a unique collaborative practice model (CPM) consisting of an integrated, multidisciplinary team within primary care. In the CPM study, 163 children from a safety-net health system were enrolled; of those, an ACEs questionnaire was collected from 158 (97%) study participants as part of their mental health evaluation. The sample was highly ACEs exposed, with 40% of children and 56% of teens having scores of four or more. There were significant associations between level of ACEs exposure and degree of mental health impairment in both children and teens. Providers viewed the ACEs assessment process as feasible, acceptable, and to have utility for the care of the study's diverse pediatric population. 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引用次数: 7
摘要
现在人们已经很清楚,童年不良经历(ace)与一生的健康和幸福呈负相关。尽管缺乏在常规护理中评估和应对风险的完善指导方针,但为了破坏ace暴露及其影响,在全国范围内开展了在初级保健中筛查ace的运动。此外,发展对文化有反应的不良经历评估模型是必要的,特别是因为种族和少数民族人口面临着不成比例的不良经历暴露风险和保健质量的差异。采用混合方法,我们通过独特的合作实践模型(CPM),包括一个综合的、多学科的初级保健团队,探索了在不同种族和经济背景的儿科人群中进行ace常规询问的可行性、可接受性和实用性。在CPM研究中,来自安全网卫生系统的163名儿童被纳入;其中,从158名(97%)研究参与者中收集了ace问卷,作为他们心理健康评估的一部分。这些样本的ace暴露程度很高,40%的儿童和56%的青少年得分在4分以上。在儿童和青少年中,ace暴露水平与心理健康损害程度之间存在显著关联。提供者认为ace评估过程是可行的,可接受的,并且对研究中不同儿科人群的护理有实用价值。研究结果强调了通过初级保健综合ace评估模型促进卫生公平的益处、挑战、文化考虑和建议。(PsycInfo Database Record (c) 2021 APA,版权所有)。
Pediatric ACES assessment within a collaborative practice model: Implications for health equity.
It is now well understood that exposure to Adverse Childhood Experiences (ACEs) is negatively linked to health and well-being across the lifespan. In an effort to disrupt ACEs exposure and its effects, there is a nationwide movement to screen for ACEs in primary care, despite a lack of well-established guidelines for assessing and responding to risk within routine care. Additionally, developing culturally responsive models of ACEs assessment is imperative, particularly because racial and ethnic minority populations face disproportionate risk of exposure to ACEs and disparities in quality of health care. Using mixed methods, we explored the feasibility, acceptability, and utility of conducting ACEs routine inquiry with an ethnically and economically diverse pediatric population through a unique collaborative practice model (CPM) consisting of an integrated, multidisciplinary team within primary care. In the CPM study, 163 children from a safety-net health system were enrolled; of those, an ACEs questionnaire was collected from 158 (97%) study participants as part of their mental health evaluation. The sample was highly ACEs exposed, with 40% of children and 56% of teens having scores of four or more. There were significant associations between level of ACEs exposure and degree of mental health impairment in both children and teens. Providers viewed the ACEs assessment process as feasible, acceptable, and to have utility for the care of the study's diverse pediatric population. Findings highlight benefits, challenges, cultural considerations and recommendations for promoting health equity through a primary-care integrated ACEs assessment model. (PsycInfo Database Record (c) 2021 APA, all rights reserved).