Advancing a national cradle-to-grave-to-cradle public health agenda

Bloom, Sandra L.

doi:10.1080/15299732.2016.1164025

Cited by 25 publications

(21 citation statements)

References 24 publications

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“…10,19 The high prevalence of ACEs in the child and adult population combined with evidence on their effect on health, life satisfaction, and social and medical care costs 10,19,21–23 have now positioned ACEs as a matter of public health in the United States as well as globally. 16–19,24,25 In this article we focus on the measurement of ACEs of children and families in research, public health, and clinical practice.…”

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confidence: 99%

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

Bethell

Carle

Hudziak

et al. 2017

Academic Pediatrics

373

249

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Background Advances in human development sciences point to tremendous possibilities to promote healthy child development and well-being across life by proactively supporting safe, stable and nurturing family relationships (SSNRs), teaching resilience, and intervening early to promote healing the trauma and stress associated with disruptions in SSNRs. Assessing potential disruptions in SSNRs, such as adverse childhood experiences (ACEs), can contribute to assessing risk for trauma and chronic and toxic stress. Asking about ACEs can help with efforts to prevent and attenuate negative impacts on child development and both child and family well-being. Many methods to assess ACEs exist but have not been compared. The National Survey of Children’s Health (NSCH) now measures ACEs for children, but requires further assessment and validation. Methods We identified and compared methods to assess ACEs among children and families, evaluated the acceptability and validity of the new NSCH-ACEs measure, and identified implications for assessing ACEs in research and practice. Results Of 14 ACEs assessment methods identified, 5 have been used in clinical settings (vs public health assessment or research) and all but 1 require self or parent report (3 allow child report). Across methods, 6 to 20 constructs are assessed, 4 of which are common to all: parental incarceration, domestic violence, household mental illness/suicide, household alcohol or substance abuse. Common additional content includes assessing exposure to neighborhood violence, bullying, discrimination, or parental death. All methods use a numeric, cumulative risk scoring methodology. The NSCH-ACEs measure was acceptable to respondents as evidenced by few missing values and no reduction in response rate attributable to asking about children’s ACEs. The 9 ACEs assessed in the NSCH co-occur, with most children with 1 ACE having additional ACEs. This measure showed efficiency and confirmatory factor analysis as well as latent class analysis supported a cumulative risk scoring method. Formative as well as reflective measurement models further support cumulative risk scoring and provide evidence of predictive validity of the NSCH-ACEs. Common effects of ACEs across household income groups confirm information distinct from economic status is provided and suggest use of population-wide versus high-risk approaches to assessing ACEs. Conclusions Although important variations exist, available ACEs measurement methods are similar and show consistent associations with poorer health outcomes in absence of protective factors and resilience. All methods reviewed appear to coincide with broader goals to facilitate health education, promote health and, where needed, to mitigate the trauma, chronic stress, and behavioral and emotional sequelae that can arise with exposure to ACEs. Assessing ACEs appears acceptable to individuals and families when conducted in population-based and clinical research contexts. Although research to date and neurobiological findings compel early ide...

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confidence: 99%

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

Bethell

Carle

Hudziak

et al. 2017

Academic Pediatrics

373

249

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“…The boundaries of bill sections were delineated by the headings “Sec.” before and after the mentions trauma-informed practice. In this article, bills that included trauma-informed language are referred to as “trauma-informed bills” and bill sections that included trauma-informed language referred to as “trauma-informed sections.” Preliminary coding categories and sub-categories were established a priori based on an earlier policy mapping study of federal legislative proposals to address post-traumatic stress disorder (PTSD) (Purtle, 2014) and scholarship about trauma-informed policy (Ardino, 2014; Bloom, 2016; Bowen & Murshid, 2016; Fairbank & Gerrity, 2007; Gerrity, 2007; ISTSS, 2010; Shern et al, 2016; Shonkoff & Fisher, 2013). …”

Section: Methodsmentioning

confidence: 99%

“…Within this context of growing interest in trauma-informed practice, mental health researchers and practitioners have called for the translation of trauma-informed practice into public policy (Ardino, 2014; Bloom, 2016; Bowen & Murshid, 2016; Fairbank & Gerrity, 2007; Gerrity, 2007; ISTSS, 2010; NCTSN; Shern, Blanch, & Steverman, 2016; Shonkoff & Fisher, 2013). As Bowen and Murshid (2016) describe, “Now, therefore, is an opportune time for public health and allied fields to expand on the shift toward trauma-informed care already underway in the service system and promote a parallel transformation in social policy.” (p. 228) Despite enthusiasm about the notion of trauma-informed policy—and its potential to maximize the public health impact of traumatic stress research (Sorenson, 2002; Thoits, 2010)—no empirical studies have investigated if and how the construct of trauma-informed practice has been integrated into public policy proposals.…”

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confidence: 99%

Mapping “Trauma-Informed” Legislative Proposals in U.S. Congress

Purtle

Lewis

2017

Adm Policy Ment Health

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Despite calls for translation of trauma-informed practice into public policy, no empirical research has investigated how the construct has been integrated into policy proposals. This policy mapping study identified and analyzed every bill introduced in US Congress that mentioned “trauma-informed” between 1973 and 2015. Forty-nine bills and 71 bill sections mentioned the construct. The number of trauma-informed bills introduced annually increased dramatically, from 0 in 2010 to 28 in 2015. Trauma-informed bill sections targeted a range of sectors, but disproportionally focused on youth (73.2%). Only three bills defined “trauma-informed.” Implications within the context of a changing political environment are discussed.

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“…Previous research has consistently demonstrated that trauma can adversely affect children's social, emotional, physical, and neurological development, especially when trauma is experienced during the critical period of early childhood (van der Kolk, ; Siegel, ). Traumatic life experiences can be detrimental for children's health and social outcomes, behaviour, and mental health (Bloom, ), and can profoundly impact on the child's well‐being across their life‐course (Hummer, Dollard, Robst, & Armstrong, ). Trauma occurs when an individual experiences an intense event that harms or threatens harm to their physical or emotional well‐being or to someone close to them, for example, a family member or friend (van der Kolk, ).…”

Section: Introductionmentioning

confidence: 99%

“…Traumatic life experiences can be detrimental for children's health and social outcomes, behaviour, and mental health (Bloom, 2016), and can profoundly impact on the child's well-being across their life-course (Hummer, Dollard, Robst, & Armstrong, 2010). Trauma occurs when an individual experiences an intense event that harms or threatens harm to their physical or emotional well-being or to someone close to them, for example, a family member or friend (van der Kolk, 2007).…”

Section: Introductionmentioning

confidence: 99%

Systematic review of organisation‐wide, trauma‐informed care models in out‐of‐home care (Oo HC ) settings

Bailey

Klas

Green

et al. 2018

Health Soc Care Community

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Trauma in early childhood has been shown to adversely affect children's social, emotional, and physical development. Children living in out-of-home care (OoHC) have better outcomes when care providers are present for children, physically, psychologically, and emotionally. Unfortunately, the high turnover of out-of-home carers, due to vicarious trauma (frequently resulting in burnout and exhaustion) can result in a child's trauma being re-enacted during their placement in OoHC. Organisation-wide therapeutic care models (encompassing the whole organisation, from the CEO to all workers including administration staff) that are trauma-informed have been developed to respond to the complex issues of abuse and neglect experienced by children who have been placed in OoHC. These models incorporate a range of therapeutic techniques, and provide an overarching approach and common language that is employed across all levels of the organisation. The aim of this study was to investigate the current empirical evidence for organisation-wide, trauma-informed therapeutic care models in OoHC. A systematic review searching leading databases was conducted for evidence of organisation-wide, trauma-informed, out-of-home care studies, between 2002 and 2017. Seven articles were identified covering three organisational models. Three of the articles assessed the Attachment Regulation and Competency framework (ARC), one study assessed the Children and Residential Experiences programme (CARE), and three studies assessed The Sanctuary Model. Risk of bias was high in six of the seven studies. Only limited information was provided on the effectiveness of the models identified through this systematic review, although the evidence did suggest that trauma-informed care models may have significantly positive outcomes for children in OoHC. Future research should focus on evaluating components of trauma-informed care models and assessing the efficacy of the various organisational care models currently available.

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Advancing a national cradle-to-grave-to-cradle public health agenda

Cited by 25 publications

References 24 publications

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

Methods to Assess Adverse Childhood Experiences of Children and Families: Toward Approaches to Promote Child Well-being in Policy and Practice

Mapping “Trauma-Informed” Legislative Proposals in U.S. Congress

Systematic review of organisation‐wide, trauma‐informed care models in out‐of‐home care (Oo HC ) settings

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