Factors for improving short- and long-term health outcomes for children who have experienced adversity and trauma

Abstract

This thesis is comprised of a comprehensive literature review focused on identifying factors that protect children from early adversity and a proposed intervention and accompanying program evaluation intended to improve health outcomes for traumatized children. The literature review summarizes the impact and prevalence of adverse childhood experiences and provides evidence for a hypothesized mechanism by which ACEs damage health: ACEs induce neuroendocrine changes while simultaneously predisposing children to engage in health risk behaviors. This literature review identifies and documents evidence for five modifiable resilience factors to improve the long- and short-term health outcomes for children who have experienced early adversity. They include improving parenting, enhancing social support, supporting maternal mental health, teaching self-care skills, and fostering understanding of trauma. The thesis proposes a pilot trauma-informed medical home (TIMH) designed to leverage the identified modifiable resilience factors for a group of pediatric patients in CPS custody at a large urban pediatric practice. The thesis includes an evaluation plan to formatively and summatively gain insight into TIMH’s effectiveness and enable program improvement.