Trauma informed public health nursing visits to parents and children

Abstract

Adverse Childhood Experiences (ACEs) research has demonstrated a strong correlation between a traumatic childhood and poor health and social status in adulthood. Maternal/child Public Health Nursing (PHN) home visiting teams frequently encounter families experiencing trauma, thus offering a unique opportunity to assist parents in recognizing the potential harm such stress may have for their child. The Sonoma County Field Nursing team developed a trauma‐informed model utilizing ACEs education in a self‐reflective approach with parents to increase family resilience and reduce the risk for future childhood trauma. This paper presents the supporting research used to develop the trauma‐informed approach and describes the execution of the model by the Sonoma County Field Nursing team.

Trauma-Informed Home Visiting Models in Public Health Nursing: An Evidence-Based Approach

“…Preliminary findings of the TIA PHN pilot revealed that clients achieved 80%-100% of health-related outcome measure goals when receiving this approach an average of 12 times over approximately 6 months. 6 The TIA PHN model represents an evidence-informed approach in the process of evaluation with aspirations of eventually becoming an evidence-based model to meet the needs of families with historical and emerging trauma. TIA PHN hopes to impact on the disruption of intergenerational trauma in line with our state's goals.…”

“…36 TIA PHN is an example of an innovative, evidence-informed maternal-child HV approach that acknowledges and addresses the effects of toxic childhood stress to break the cycle of intergenerational trauma. 6 In 2017, rates of homelessness, intimate partner violence, and mental health concerns among families enrolling in the Sonoma County Field Nursing program increased by 17-28% in the months immediately following the 2017 Sonoma Complex Fire, which destroyed more than 5,300 homes and significantly affected the community's overall economy and safety net. 37 Since 2017, the county has experienced nearly annual wildfires, flooding, and the COVID-19 pandemic.…”

“…After initial pilot work in Sonoma County, the TIA PHN model is currently in an expanded 30month pilot phase in the counties of Napa, San Francisco, and Sonoma. 6 In partnership with a nursing academic partner and with funding from the California Home Visiting Program (CHVP), the goal of this work is to advance the TIA PHN model from evidence-informed to evidencebased status so that it may be disseminated widely and supported through government funding.…”

“…Since 2017, the Sonoma County Field Nursing team has been developing and implementing a Trauma Informed Approach in Public Health Nursing (TIA PHN) HV program to mitigate toxic stress, improve resilience, and optimize health among low-income families who are at high risk for trauma and who are experiencing medical and/or social challenges. 6 Currently being piloted in three Northern California counties, the TIA PHN model is not yet considered evidence-based but represents a promising HV alternative for families affected by trauma. We describe the evolution of HV models and argue that innovation in addition to fidelity to evidence-based practice should be considered for HV and field nursing in the community.…”

The Roadmap for Resilience: The California Surgeon General's Report on Adverse Childhood Experiences, Toxic Stress, and Health

“…977,1318 Nurses and other home visiting professionals provide guidance, coaching, and access to health and social services and have been trained on intercultural competence, trauma-informed care, and disproportionality. 1319,1320 Services were modified as appropriate during the coronavirus disease 2019 (COVID-19) pandemic (see ADAPTATIONS TO THE COVID-19 PANDEMIC).…”