Name
Poster 77 - Investigating Protective Factors Against Adverse Childhood Experiences in Primary Care: A Systematic Review Utilizing the Socio-Ecological Resiliency Model
Date & Time
Friday, October 25, 2024, 5:00 PM - 6:30 PM
Location Name
Lone Star Ballroom Prefunction Area
Description

Adverse childhood experiences (ACEs) have a significant impact on physical and mental health throughout an individual's life. While there is extensive research on ACEs assessments in primary care (PC), there is less understanding of protective factors, which are essential for fostering resilience. This systematic review, utilizing Ungar's Socio-ecological Resilience Model, explored how protective factors are evaluated in PC screenings for ACEs and their potential effects on patient health outcomes. Searches were conducted in PubMed, PsycINFO, and CINAHL databases up to September 30, 2022, without restrictions on language or country. A comprehensive search strategy across these databases identified 764 initial studies. After removing duplicates and undergoing a two-stage review process with inter-rater agreement (Cohen's κ = .583, .677), 27 studies met the inclusion criteria. These studies screened adult patients (≥18 years) for ACEs in PC settings and assessed at least one protective factor. The results were qualitatively synthesized, revealing significant variability in the specific protective factors measured. According to Ungar's model, frequently assessed individual factors included relationships, identity, and power/control, while community/social factors such as cohesion, material resources, and social justice were also common. Only two studies adequately addressed cultural adherence. These findings highlight potential gaps in understanding how specific protective factors can enhance biopsychosocial-spiritual health in PC settings, particularly within diverse cultural contexts. The review emphasizes the need for PC research to expand its focus to a broader range of protective factors and their potential to alleviate the effects of ACEs. It underscores the importance of Ungar's Socio-ecological model for its comprehensiveness while calling for more culturally sensitive assessment tools and interventions. Identifying the most effective protective factors in PC settings could enable targeted support and optimize patient health outcomes.

Speakers
Betül Küçükardalı Cansever MA, PhD Candidate, East Carolina University, Greenville, NC
Angela Lamson PhD, LMFT, Professor, East Carolina University, Greenville, NC
Abby Caldwell,
Betül Küçükardalı Cansever Angela Lamson
Co-Authors
Abby Caldwell, Natalia Sira, Angela Lamson
Content Level
All Audience
Tags
Social determinants of health (SDoH)
Session Type
Poster
Handout 1 Link
View Handout 1
Objective 1
Identify key protective factors against Adverse Childhood Experiences (ACEs) that can be integrated into primary care settings.
Objective 2
Describe the socio-ecological resilience framework and its application in evaluating and addressing ACEs within primary care.
Objective 3
Discuss the implications of incorporating protective and compensatory childhood experiences into patient treatment plans to mitigate negative health outcomes associated with ACEs.
Content Reference 1

Hays-Grudo, J., & Morris, A. S. (2020). Adverse and protective childhood experiences: A developmental perspective. American Psychological Association. https://doi.org/10.1037/0000177-000

Content Reference 2

Bethell, C., Jones, J., Gombojav, N., Linkenbach, J., & Sege, R. (2019). Positive childhood experiences and adult mental and relational health in a statewide sample. JAMA Pediatrics, 173(11), e193007. https://doi.org/10.1001/jamapediatrics.2019.3007

Content Reference 3

Ross, N., Gilbert, R., Torres, S., Dugas, K., Jefferies, P., McDonald, S., Savage, S., & Ungar, M. (2020). Adverse childhood experiences: Assessing the impact on physical and psychosocial health in adulthood and the mitigating role of resilience. Child Abuse & Neglect, 103, 104440. https://doi.org/10.1016/j.chiabu.2020.104440

Content Reference 4

Ungar, M., Theron, L., Murphy, K., & Jefferies, P. (2021). Researching multisystemic resilience: A sample methodology. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.607994

Content Reference 5

Cansever., B. K., Lamson, A., Sira, N., Bridgland, S. A., Eagan, S., & Roberts, E. (2024). Adverse childhood experiences (ACEs) screening in primary care settings for adults: A systematic review. [Manuscript accepted with revisions for publication].