Kristen R Choi1, Michael McCreary2, Julian D Ford3, Sara Rahmanian Koushkaki2, Kristen N Kenan4, Bonnie T Zima2. 1. Division of General Internal Medicine and Health Services Research, National Clinician Scholars Program and krchoi@ucla.edu. 2. Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California. 3. Department of Psychiatry, University of Connecticut, Mansfield, Connecticut; and. 4. Department of Pediatrics, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
Abstract
OBJECTIVES: Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. METHODS: In this cross-sectional, descriptive study, we used a sample of 261 children (3-16 years old) who were seeking services at a Federally Qualified Health Center with colocated behavioral health services in Chicago and had a positive Pediatric Symptom Checklist screen result or received a referral for behavioral health evaluation. The TESI was adapted as a screening tool to be sensitive to adverse childhood experiences (ACEs) unique to the clinic communities. ACEs were mapped by zip code with objective neighborhood crime data, and latent class analysis was performed to identify ACE subgroups. RESULTS: The mapping validation suggested face validity for geographic overlap between participant ACEs and objective violent-crime occurrence. With latent class analysis, we identified 3 ACE subgroups: (1) high ACE (18.0% of the sample; polyvictimization and/or maltreatment), (2) moderate ACE (52.1%; violent environments), and (3) low ACE (29.9%; few adverse experiences). Membership in the high-ACE subgroup was associated with higher odds of a clinically significant Pediatric Symptom Checklist score (odds ratio = 3.83) and clinical-level attention problems (odds ratio = 3.58) even after accounting for child resilience and parent depression. CONCLUSIONS: ACEs play a significant role in predicting a need for behavioral health services among children seeking primary-care services. The community-adapted TESI is a valid ACE screening tool.
OBJECTIVES: Our purpose in this study was to adapt and validate the Traumatic Events Screening Inventory (TESI) as a primary-care childhood adversity screening tool for children living in vulnerable neighborhoods using a community-partnered approach. METHODS: In this cross-sectional, descriptive study, we used a sample of 261 children (3-16 years old) who were seeking services at a Federally Qualified Health Center with colocated behavioral health services in Chicago and had a positive Pediatric Symptom Checklist screen result or received a referral for behavioral health evaluation. The TESI was adapted as a screening tool to be sensitive to adverse childhood experiences (ACEs) unique to the clinic communities. ACEs were mapped by zip code with objective neighborhood crime data, and latent class analysis was performed to identify ACE subgroups. RESULTS: The mapping validation suggested face validity for geographic overlap between participant ACEs and objective violent-crime occurrence. With latent class analysis, we identified 3 ACE subgroups: (1) high ACE (18.0% of the sample; polyvictimization and/or maltreatment), (2) moderate ACE (52.1%; violent environments), and (3) low ACE (29.9%; few adverse experiences). Membership in the high-ACE subgroup was associated with higher odds of a clinically significant Pediatric Symptom Checklist score (odds ratio = 3.83) and clinical-level attention problems (odds ratio = 3.58) even after accounting for child resilience and parent depression. CONCLUSIONS: ACEs play a significant role in predicting a need for behavioral health services among children seeking primary-care services. The community-adapted TESI is a valid ACE screening tool.
Authors: Kelsey J Sala-Hamrick; Brian Isakson; Sara Del Campo De Gonzalez; Agatha Cooper; John Buchan; Javier Aceves; Elizabeth Van Orton; Jill Holtz; Destiny M Waggoner Journal: J Behav Health Serv Res Date: 2021-01-07 Impact factor: 1.505
Authors: Michael Lindsey; Kathrine Sullivan; Claude Chemtob; Kelly Ancharski; James Jaccard; Marylène Cloitre; Anthony Urquiza; Susan Timmer; Mercedes Okosi; Debra Kaplan Journal: Trials Date: 2022-05-23 Impact factor: 2.728