P0235 - Teaching Interventions for Adverse Childhood Experiences (ACEs): A Systematic Review

Background: Understanding the impact of ACEs on lifelong health and morbidity is critical, but it is and provision of trauma-informed care (TIC).

Objective: To conduct a systematic review to assess teaching interventions being used to teach TIC to medical trainees and medical staff.
Design/

Methods: We searched Pubmed, Embase, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, and PsychInfo. The initial search identified 1,965 citations. After duplicates were removed, 1207 citations underwent title and abstract screening by two content area experts.

Results: We independently reviewed 1207 abstracts, and we determined 55 met criteria for inclusion. We analyzed 55 articles using a data abstraction form. We categorized articles by the following topics: adverse childhood experiences (ACEs), trauma-informed care (TIC), child abuse/maltreatment, domestic violence, intimate partner violence (IPV), child neglect, substance abuse, parental mental illness, child safeguarding, elder abuse, and child & adolescent advocacy. We found 18 articles included teaching interventions for medical professionals, including physicians, residents, nurse practitioners, registered nurses, and social workers (Table 1). Of these, 8 articles detailed teaching on ACEs and TIC, although the duration (range 15 minutes to semester-long trainings) and content of the teaching intervention were highly variable. Four studies included emergency department trainings on child abuse (Table 2), 7 studies focused on medical and nursing students (Table 3), and 3 non U.S. studies focused on nurses (Table 4).
Conclusion(s): While ACEs have lasting implications on health outcomes and trajectories, there are limited studies detailing medical curricula to teach broad-based concepts of ACEs and TIC in clinical settings. This suggests there are opportunities to expand teaching for the next generation of medical providers to provide trauma-informed care.
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(we have 4 data tables, but are able to upload only 1) tables available upon request