Online Program

Primary Prevention of Childhood Adversity and Mitigation of Toxic Stress in Early Childhood through Trauma-Informed Group Well Child Care

Wednesday, November 4, 2015 : 11:10 a.m. - 11:30 a.m.

Lauren Graber, MD, Department of Family Medicine, Boston University / Boston Medical Center, Boston, MA
Sanam Roder-DeWan, MD, Maternal Child Health, Codman Square Health Center, Dorchester, MA
Morgan Brockington, CLC, Vital Village Network, Boston Medical Center, Boston, MA
Tamiya Tabb, Maternal Child Health, Codman Square Health Center, Dorchester, MA
Renee Boynton-Jarrett, MD, ScD, General Pediatrics, Boston University School of Medicine / Boston Medical Center, Boston, MA
Background: Strengthening parenting skills and reducing parental stress can optimize a child’s health and developmental trajectory. Despite existing models of trauma-informed care, there is a paucity of research on the primary prevention of child adversity and toxic stress in primary care settings. Group Well Child Care (GWCC) is a group-based healthcare approach that empowers parents to share, learn, and make meaningful change. This study examined the impact of a trauma-informed GWCC on caregivers’ ability to mitigate early childhood toxic stress in a community health center that serves an urban, low-income population.

Methods: The curriculum was developed through an iterative process among health providers and community case managers. Three focus groups of parents who participated in GWCC (N=17) were conducted, audiotaped, and synthesized into common themes using thematic framework analysis with four independent coders and iterative discussion to reach consensus.

Results: Three unifying themes were present. (1) GWCC is a safe space for parents to create connections that empower them to understand and recognize toxic stress; (2) Discussion about toxic stress and brain development enables parents to identify that they are a “mirror” for their child; (3) Activities that facilitate reflection on relationships and anger management encourage intentional parenting and alter behaviors.

Conclusion: Our qualitative findings suggest that trauma-informed GWCC supports the primary prevention of childhood adversity and toxic stress by creating connections between parents, helping families understand and identify toxic stress, and teaching reflective parenting and anger management skills that mitigate stressors.

Learning Areas:

Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Social and behavioral sciences

Learning Objectives:
Describe the potential of Group Well Child Care to inform parents about the impact of toxic stress on brain development and empower intentional parenting. Identify specific activities in Group Well Child Care to facilitate discussions around toxic stress and anger management.

Keyword(s): Stress, Child Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a resident physician working in group health care models for two years within an urban, underserved population with significant trauma. I have facilitated a multidisciplinary research team to create a curriculum in trauma-informed care for group well child care which have been piloted by me and my colleagues.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.