Adverse childhood experiences and sources of childhood resilience: a retrospective study of their combined relationships with child health and educational attendance
Adverse childhood experiences and sources of childhood resilience: a retrospective study of their combined relationships with child health and educational attendance
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DOI：
10.1186/s12889-018-5699-8
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发表时间：
2018-06-26
影响因子：
4.5
通讯作者：
Davies, Alisha
中科院分区：
文献类型：
--
作者：
Bellis, Mark A.;Hughes, Karen;Davies, Alisha
背景：不良童年经历（ACE）包括虐待和暴露于家庭压力源可以影响儿童的健康。提供支持、友谊和发展机会的社区因素可以培养儿童的复原力，保护他们免受ACE的某些有害影响。我们研究ACE的历史是否与儿童健康状况不佳和入学率以及在何种程度上抵消了社区弹性assets.Methods：一个国家（威尔士）的横截面回顾性调查（n = 2452）使用分层随机概率抽样方法，包括一个助推样本（n = 471）的威尔士语。在参与者的居住地进行面对面的访谈，收集数据。结果的措施是自我报告的儿童健康状况不佳，具体的条件（哮喘，过敏，头痛，消化系统疾病）和学校absenteism.Results：每个常见的儿童条件，儿童健康状况不佳和学校缺勤的患病率增加ACE报告的数量。童年社区复原力资产（被公平对待，支持童年的朋友，有机会使用你的能力，获得信任的成年人和有一个值得尊敬的人）与更好的结果独立相关。在那些有>= 4个ACE的儿童中，所有显著弹性资产的存在（与无）将儿童健康不良的调整患病率从59.8%降低到21.3%。结论：通过公共服务的联合行动更好地预防ACE可能会降低儿童常见疾病的水平，提高入学率，并有助于减轻公共服务的压力。虽然消除ACE仍然不太可能，但加强社区复原力资产的行动可能会部分抵消其直接危害。
Background: Adverse childhood experiences (ACEs) including maltreatment and exposure to household stressors can impact the health of children. Community factors that provide support, friendship and opportunities for development may build children's resilience and protect them against some harmful impacts of ACEs. We examine if a history of ACEs is associated with poor childhood health and school attendance and the extent to which such outcomes are counteracted by community resilience assets.Methods: A national (Wales) cross-sectional retrospective survey (n = 2452) using a stratified random probability sampling methodology and including a boost sample (n = 471) of Welsh speakers. Data collection used face-to-face interviews at participants' places of residence. Outcome measures were self-reported poor childhood health, specific conditions (asthma, allergies, headaches, digestive disorders) and school absenteeism.Results: Prevalence of each common childhood condition, poor childhood health and school absenteeism increased with number of ACEs reported. Childhood community resilience assets (being treated fairly, supportive childhood friends, being given opportunities to use your abilities, access to a trusted adult and having someone to look up to) were independently linked to better outcomes. In those with >= 4 ACEs the presence of all significant resilience assets (vs none) reduced adjusted prevalence of poor childhood health from 59.8 to 21.3%.Conclusions: Better prevention of ACEs through the combined actions of public services may reduce levels of common childhood conditions, improve school attendance and help alleviate pressures on public services. Whilst the eradication of ACEs remains unlikely, actions to strengthen community resilience assets may partially offset their immediate harms.