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Promoting Equity and Resilience: Wellness Navigators' Role in Addressing Adverse Childhood Experiences

机译:促进公平和韧性:健康航海家的角色在应对不利的童年经历

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摘要

Objective: Adverse childhood experiences (ACEs) have demonstrable negative effects on long-term physical and mental health. Racial and ethnic minority children disproportionally experience ACEs due to the impacts of structural inequality and discrimination, which could drive health disparities. Pediatric settings offer an opportune context to address ACEs and improve health equity, and to link families to the necessary resources to promote resilience. Wellness navigators (WNs), who can reflect patients' cultural, linguistic, and other shared characteristics, have the potential to improve patient care and integrated behavioral health services to mitigate the public health impact of ACEs. In the current study, bilingual and bicultural WNs helped to deliver ACEs screening and response to predominately Latinx patients in a pediatric service setting. Methods: Quantitative data on referrals made by WNs and qualitative interviews were analyzed to understand the role of WNs in ACEs screening. Results: Among families (infants and caregivers) that screened positive for ACEs, WNs addressed social determinants of health and, based on individual needs assessments, made referrals to community resources in over half of the cases. Insurance, childcare, and housing were the most frequent referral sources. WNs supported caregivers in initiating services with 94% of the referrals that were made. Qualitative interviews with medical providers and caregivers underscored WNs' role in the ACEs screening process. Implications for ACEs screening, trauma-responsive pediatric care, and integrating WNs into an integrated behavioral health team are discussed.
机译:摘要目的:儿童期不良经历(ace)对长期有明显的负面影响身心健康。少数民族的孩子不成比例地经验ace由于结构性不平等的影响和歧视,这可能推动健康差异。合适的上下文解决ace和改善卫生公平,家庭的联系必要的资源,促进弹性。健康航海家(白鼻综合症),谁能反映患者的文化、语言和其他共享特点,有可能改善病人护理和综合行为健康服务,减轻公共卫生的影响ace。二元文化的白鼻综合症帮助交付ace筛查和应对主要Latinx病人儿科服务设置。推荐由白鼻综合症和定量数据定性访谈进行了分析理解白鼻综合症在ace筛查中的作用。结果:在家庭(婴儿和照顾者)筛选阳性ace,白鼻综合症健康问题社会决定因素,基于个人需求评估,做出推荐在超过一半的情况下社区资源。保险、儿童保育和住房是最频繁的推荐来源。以94%的护理人员在启动服务推荐了。与医疗提供者和医护人员强调白鼻综合症”在ace筛选过程中的作用。对ace筛查,trauma-responsive儿科护理,和集成白鼻综合症到一个综合的行为健康的团队进行了讨论。

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