Child Adversity and Trauma-Informed Care Teaching Interventions: A Systematic Review

Abstract

OBJECTIVES: Health professionals need training to provide trauma-informed care (TIC) for children with adverse childhood experiences (ACEs), which can affect short- and long-term health. We summarize and evaluate published curricula for health professionals on ACEs and TIC. METHODS: We searched PubMed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, PsychInfo, and MedEdPORTAL through January 2021. Studies meeting the following criteria were included: Described teaching interventions on ACEs, TIC, and child abuse and maltreatment; included health care providers or trainees as learners; were written in English; included an abstract; and described a curriculum and evaluation. We reviewed 2264 abstracts, abstracted data from 79 studies, and selected 51 studies for qualitative synthesis. RESULTS: Studies focused on ACEs/TIC (27), child abuse (14), domestic/intimate partner violence (6), and child maltreatment/parental physical punishment (4). Among these 51 studies, 43 were published since 2010. Learners included a mix of health professionals (34) and students (17). Duration, content, and quality of the 51 curricula were highly variable. An analysis of 10 exemplar curricula on ACEs and/or TIC revealed high and very high quality for methods and moderate to very high quality for curriculum evaluation, suggesting that they may be good models for other educational programs. Four of the 10 exemplars used randomized controlled trials to evaluate efficacy. Studies were limited to English language and subject to publication bias. CONCLUSIONS: ACEs and TIC are increasingly relevant to teaching health professionals, especially pediatricians, and related teaching curricula offer good examples for other programs.

Mental health associated with the cluster of childhood trauma and resilience among nursing students: A cross-sectional study.

“…Our findings also implied the importance to screen for at-risk students. Psychological interventions that have been proven to be effective in reducing psychological problems following trauma, such as psychoeducation (Steen et al, 2022), narrative approaches (Niwa et al, 2022), and cognitive behavior therapy (Cohen et al, 2018; Coventry et al, 2020), are warranted for those with childhood trauma experiences. In particular, proactive intervention approaches should focus on nursing students with mild childhood trauma and low resilience to achieve optimal cost-effectiveness.…”

How the police conceptualise and view the relevance of adverse childhood experiences (ACEs) for policing: a qualitative investigation

“…Evidence from other sectors, such education and healthcare, suggests that ACEs training can positively impact staff attitudes and behaviour (Miller-Cribbs et al, 2020;Steen et al, 2022). However, the police is an institution with organisational and cultural features that differentiates it from other public-facing services (Brough et al, 2016;Kurtz, 2008) and there is paucity of research on police officers' responses to ACEs training.…”

“…The shift towards a culture where individuals believe in the value of traumainformed working requires staff to be aware of prevalence and impact of early trauma (Elliott et al, 2005), and ACEs training has been shown to result in positive attitude change for service users and staff in a number of sectors (Miller-Cribbs et al, 2020;Steen et al, 2022). In addition, there is limited evidence that ACEs interventions lead to positive attitude change in police, but limited evidence of change in behaviour (Ford et al, 2017).…”

“…Evidence from other sectors, such education and healthcare, suggests that ACEs training can positively impact staff attitudes and behaviour (Miller-Cribbs et al. , 2020; Steen et al. , 2022).…”

“…, 2005), and ACEs training has been shown to result in positive attitude change for service users and staff in a number of sectors (Miller-Cribbs et al. , 2020; Steen et al. , 2022).…”