Implementation of the adverse childhood experiences conversation in primary care
Implementation of the adverse childhood experiences conversation in primary care
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DOI：
10.1093/fampra/cmz065
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发表时间：
2020-06-01
期刊：
影响因子：
2.2
通讯作者：
Olson-Dorff, Denyse
中科院分区：
文献类型：
--
作者：
Bodendorfer, Victoria;Koball, Afton M.;Olson-Dorff, Denyse
背景。研究重点是筛查不良童年经历，而不是将教育作为常规预期指导的一部分。不良童年经历“对话”是一种尚未经过实证研究的方法，但代表了一种补充或替代的筛查方法，可以克服许多现有的障碍。 目标。本研究旨在检查家长/监护人和提供者在初级保健中的健康儿童就诊期间不良童年经历对话的可接受性/可行性。方法。在家庭医学住院医师诊所的儿童健康探访期间，提供者与患者的父母/监护人进行对话。访问后对家长/监护人和提供者进行了调查，以检查可接受性和可行性。进一步检查提供商观点的季度评估已经完成。数据收集1年。结果。总共完成了 238 份家长/监护人和 231 份提供者调查。大多数家长/监护人对所讨论的信息感到积极（76%）和舒适（81%），97% 认为应该专门与他们的初级保健提供者进行对话。大多数提供者 (71%) 表示家长/监护人愿意接受对话，对话持续 1-2 分钟 (60%)，并且很少披露逆境 (9%)，其中没有一个需要强制报告。结论。结果表明，不良童年经历对话受到父母/监护人和提供者的好评，并且可以在初级保健中实施。该对话可以用作筛查的补充或替代方法，以进一步传播有关有毒压力和健康的知识，为家庭提供资源并提高复原力。
Background. Research has focused on screening for adverse childhood experiences, rather than provision of education as a part of routine anticipatory guidance. An adverse childhood experiences 'conversation' is one method that has not been studied empirically but represents a complimentary or alternative approach to screening which could overcome many existing barriers.Objectives. This study aims to examine parent/guardian and provider acceptability/feasibility of the adverse childhood experiences conversation during well-child visits in primary care.Methods. Providers engaged in a conversation with parents/guardians of patients during well-child visits in a family medicine residency clinic. Parents/guardians and providers were surveyed following the visit to examine acceptability and feasibility. Quarterly assessments to further examine provider perspectives were completed. Data were collected for 1 year.Results. In total, 238 parent/guardian and 231 provider surveys were completed. Most parents/guardians felt positively (76%) about and comfortable (81%) with the information discussed and 97% felt that the conversation should be had with their primary care provider specifically. Most providers (71%) indicated that parents/guardians were receptive to the conversation, that the conversations took 1-2 minutes (60%) and that there were few disclosures of adversity (9%), none of which required mandatory reporting.Conclusions. Results suggest that the adverse childhood experiences conversation is well received by parents/guardians and providers and is feasible to implement into primary care. The conversation could be used as a complimentary or alternative method to screening to further spread knowledge of toxic stress and health, provide resources for families and promote resilience.