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.
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.
Authors: Kat Ford; Karen Hughes; Katie Hardcastle; Lisa C G Di Lemma; Alisha R Davies; Sara Edwards; Mark A Bellis Journal: Child Abuse Negl Date: 2019-03-16
Authors: Abimbola Olaniran; Helen Smith; Regine Unkels; Sarah Bar-Zeev; Nynke van den Broek Journal: Glob Health Action Date: 2017 Impact factor: 2.640
Authors: Sara Cibralic; Mafruha Alam; Antonio Mendoza Diaz; Susan Woolfenden; Ilan Katz; Dimitra Tzioumi; Elisabeth Murphy; April Deering; Lorna McNamara; Shanti Raman; Valsamma Eapen Journal: BMJ Open Date: 2022-08-25 Impact factor: 3.006