Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination

Francis, Lucine; DePriest, Kelli; Wilson, Marcella; Gross, Deborah

doi:10.3912/ojin.vol23no03man02

Cited by 56 publications

(27 citation statements)

References 61 publications

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“…Participants clicked a box next to any domain for which they wanted to receive assistance. These domains were selected because deficits in these areas have been associated with stress and negative impacts on individuals and their families in the short and long term [ 43 ]. Local community resources were identified through various methods.…”

Section: Methodsmentioning

confidence: 99%

Digital Screening and Automated Resource Identification System to Address COVID-19–Related Behavioral Health Disparities: Feasibility Study

Stiles‐Shields¹,

Batts²,

Reyes³

et al. 2022

JMIR Form Res

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Background Digital mental health (DMH) tools use technology (eg, websites and mobile apps) to conveniently deliver mental health resources to users in real time, reducing access barriers. Underserved communities facing health care provider shortages and limited mental health resources may benefit from DMH tools, as these tools can help improve access to resources. Objective This study described the development and feasibility evaluation of the Emotional Needs Evaluation and Resource Guide for You (ENERGY) System, a DMH tool to meet the mental health and resource needs of youth and their families developed in the context of the COVID-19 pandemic. The ENERGY System offers a brief assessment of resource needs; problem-solving capabilities; and symptoms of depression, anxiety, trauma, and alcohol and substance use followed by automated, personalized feedback based on the participant’s responses. Methods Individuals aged ≥15 years were recruited through community partners, community events, targeted electronic health record messages, and social media. Participants completed screening questions to establish eligibility, entered demographic information, and completed the ENERGY System assessment. Based on the participant’s responses, the ENERGY System immediately delivered digital resources tailored to their identified areas of need (eg, relaxation). A subset of participants also voluntarily completed the following: COVID-19 Exposure and Family Impact Survey (CEFIS) or COVID-19 Exposure and Family Impact Survey Adolescent and Young Adult Version (CEFIS-AYA); resource needs assessment; and feedback on their experience using the ENERGY System. If resource needs (eg, housing and food insecurity) were endorsed, lists of local resources were provided. Results A total of 212 individuals accessed the ENERGY System link, of which 96 (45.3%) completed the screening tool and 86 (40.6%) received resources. Participant responses on the mental health screening questions triggered on average 2.04 (SD 1.94) intervention domains. Behavioral Activation/Increasing Activities was the most frequently launched intervention domain (56%, 54/96), and domains related to alcohol or substance use were the least frequent (4%, 4/96). The most frequently requested support areas were finances (33%, 32/96), transportation (26%, 25/96), and food (24%, 23/96). The CEFIS and CEFIS-AYA indicated higher than average impacts from the pandemic (ie, average scores >2.5). Participants were satisfied with the ENERGY System overall (65%, 39/60) as well as the length of time it took to answer the questions (90%, 54/60), which they found easy to answer (87%, 52/60). Conclusions This study provided initial support for the feasibility of the ENERGY System, a DMH tool capable of screening for resource and mental health needs and providing automated, personalized, and free resources and techniques to meet the identified needs. Future studies should seek direct feedback from community members to further improve the ENERGY System and its dissemination to encourage use.

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Section: Methodsmentioning

confidence: 99%

Digital Screening and Automated Resource Identification System to Address COVID-19–Related Behavioral Health Disparities: Feasibility Study

Stiles‐Shields¹,

Batts²,

Reyes³

et al. 2022

JMIR Form Res

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“…This may include drawing from a variety of creative and reflective teaching methods in the literature to create transformative learning opportunities while engaging all students in SDH content regardless of their starting place. [33][34][35][36] Finally, preclinical curricular reform should elevate the voices of both students and faculty identifying as women and BIPOC, as these individuals are more likely to have felt the effects of social forces on health and well-being.…”

Section: Next Steps and Recommendationsmentioning

confidence: 99%

Race and Gender Differences in Medical Student Perspectives on Social Determinants of Health Education: A Single-Institution Survey Study

Shahriar¹,

Prasad²,

Casty³

et al. 2021

AMEP

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Purpose The field of medicine is becoming increasingly aware of the role that social determinants of health (SDH) play in shaping health and health outcomes. Organized medicine – including prominent physician groups and accreditation bodies – has endorsed SDH education as an integral component of medical school curricula. This study sought to describe medical student perspectives on the current state of SDH in preclinical curricula. Methods The authors developed a 9-item survey to assess time being spent on SDH and attitudes toward the current level of SDH content in preclinical curricula. All medical students at both campuses of a large public medical school were invited to participate between December 2019 and February 2020. Results Of 1010 medical students invited to participate, 515 (51.0%) responded. Of the 515 respondents, 480 (93.2%) reported spending at least 40 hours per week on medical school, and of those, 405 (84.4%) said they spend 0–2 hours on SDH. The majority of all respondents (62.1%; 320/515) felt the current level of focus on SDH is “not enough”, while only eleven students (2.1%; 11/515) felt it is “too much”. In a multiple logistic model, Black students were over four times as likely as white students (aOR 4.19; 95% CI 1.37–18.38) to feel the current level of focus on SDH is “not enough”. Likewise, women were 2.3-times (aOR 2.30; 95% CI 1.52–3.49) as likely as men to feel the level of focus on SDH is “not enough”. Conclusion In practice, medical students are spending considerably less time learning SDH than is advised by consensus of expert educators and administrators. Over sixty percent of medical students do not feel the current level of focus on SDH is sufficient. Further study is needed to determine why women and racial minority students are significantly more likely to feel this way.

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“…Interesting concentrations of high ACT scores have been found in several vulnerable populations, such as those living in poverty (Francis et al, 2018); individuals who were the victims of human trafficking (Reid et al, 2017), women of color (Corbin et al, 2013), Persons of First Nations (Nurius et al, 2016), individuals who identify as members of the LGBTQ+ community (Blosnich & Anderson, 2015), those struggling with substance use disorders (Fuller- Thomson et al, 2016), and female sex offenders (Willis & Levenson, 2016). Thomas and Jaque (2018) investigated childhood adversity in professional performing artists, and found that increased reports of childhood abuse and neglect by actors.…”

Section: Adverse Childhood Experience (Ace) and Childhood Toxic Stressmentioning

confidence: 99%

“…Due to personal experiences, perceptions of traumatic events, personality factors, temperaments, and several other nuances, no two people experience trauma in the same manner. It is also difficult to separate the effects of trauma and poverty on future outcomes (Francis et al, 2018).Therefore, it is difficult to separate the effects of trauma, personal factors, lower socioeconomic status, and resulting outcomes. Additionally, the overall sample is small (n = 95), making the results of this study primary.…”

Section: Limitationsmentioning

confidence: 99%

“…With the increased attention to the influence of trauma on life domains and outcomes, more socializing institutions are taking on the responsibility of proactively addressing unresolved traumatic issues to increase positive outcomes (Boatwright & Midcalf, 2019;Francis, DePriest, Wilson, & Gross, 2018;Moses & Villodas, 2017;Reinbergs & Fefer, 2017). Primary and secondary education are being called upon to respond to these challenges as part of their educational goals and mission.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Commonality of Emotional Trauma in Performing Arts: Implications for Training Programs

Branson¹,

Radu²

2020

JEHD

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This article examines Adverse Childhood Experiences (ACE) scores among university performing arts students, the role of trauma as a muse and creative outlet, and attraction to the performing arts as a result of experienced trauma. Descriptive and Chi Square analysis reveal significant concentrations of ACE scores were discovered in 3 of the 10 ACE categories for performing arts majors, specifically psychological abuse, emotional neglect, and having a family member with mental illness. Additionally, performing arts students (n = 95) had a higher total average ACE score compared to other majors (n = 322). Research indicates a strong correlation between number of ACE scores and negative physical and psychological outcomes in adults (Felitti et al., 1998). Numerous methods centered on difficult emotions are employed to assist performing artists in honing their craft, physically, cognitively, and psychologically; thereby creating a complex relationship between creative inspiration from past traumatic events and destructive force to the whole person. These dynamics result in implications for performing arts preparatory programs, such as how to address these issues in their curriculum for holistic education and development of one's artistic range and abilities.

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Child Poverty, Toxic Stress, and Social Determinants of Health: Screening and Care Coordination

Cited by 56 publications

References 61 publications

Digital Screening and Automated Resource Identification System to Address COVID-19–Related Behavioral Health Disparities: Feasibility Study

Digital Screening and Automated Resource Identification System to Address COVID-19–Related Behavioral Health Disparities: Feasibility Study

Race and Gender Differences in Medical Student Perspectives on Social Determinants of Health Education: A Single-Institution Survey Study

Commonality of Emotional Trauma in Performing Arts: Implications for Training Programs

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