Funded Projects

Supporting Families Impacted by ACEs

Project Year

2022

City & State

Kansas City, Missouri

Program Name

CATCH Resident

Topic

Well-Child/Well-Baby Care

Program Description

Supporting Families Impacted by Trauma through Parental ACE Screening in Primary Care: 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). The goal of this project is to identify families impacted by ACEs and provide the support they need to address them. This project plans to pilot a protocol for parental ACE screening in an Internal Medicine-Pediatrics resident clinic that cares for an underserved, urban patient population. Parental ACE screening and universal education will be completed for all parents with infants. Through a trauma informed care approach and shared decision making, families at high risk for adversity or in need of additional support will be connected to community services. Research has demonstrated that resources needed by parents to respond to ACEs primarily include education and parenting support (7,10,11), so our approach will be aimed to provide these interventions. Developing this support 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. We plan to collaborate with these organizations to develop a system for addressing ACEs in families through trauma informed care, parental education, addressing basic social needs, and providing parenting or mental health services when needed. Through this collaboration, we will develop a process for effectively connecting families with community partners to provide needed support. We will continue to meet periodically through the project to ensure this system is effective for families and community partners. In addition, we will obtain feedback from parents to help guide this process and the specific supports needed by our clinic families. This feedback will be used in conjunction with input from community organizations to assess and improve our approach. Together, this project will use a quality improvement focus, guided by community partners and families, to determine how to best mitigate the impact of ACEs in our patients.

Project Goal

Implement parental ACE screening in a primary care setting 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.

Project Objective 1

Establish community partnerships with 3-5 organizations specialized in providing services to families and children impacted by trauma or adversity in order to build a network of support for families and a system for connecting families to these services.

Project Objective 2

Determine the feasibility of parental ACE screening for families with infants in our clinic by completing ACE screening in at least 70% of targeted patients.

Project Objective 3

Determine the acceptability of parental ACE screening by parents and elicit feedback on processes for connecting to community partners and needed parental support using survey feedback from at least 50 parents within 9 months of screening.

AAP District

District VI

Institutional Name

University of Missouri - Kansas City

Contact 1

Jennifer Paumen