Provider Training for ACE Discussions in Child Development

Overseen By Abigail Lott, PhD, ABPP

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Emory University

Disqualifiers: Non-English/Spanish speakers, Under 18, Others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if discussing their own Adverse Childhood Experiences (ACEs) with caregivers can improve their children's health. It will compare two groups: one where providers receive training on ACEs and study procedures to discuss ACEs with caregivers, and another where they follow standard care but still complete surveys. The goal is to see if these discussions reduce emergency visits and missed doctor appointments for children. Caregivers who bring their children for specific well-child check-ups and speak either English or Spanish may be suitable participants. As an unphased study, this trial offers caregivers a unique opportunity to contribute to research that could enhance children's healthcare experiences.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this training protocol is safe for caregivers and children?

Research has shown that training healthcare providers to discuss Adverse Childhood Experiences (ACEs) with caregivers is generally safe. ACEs training equips providers to address difficult past experiences that might affect health. This training emphasizes conversations rather than medical treatments, so it doesn't carry the risks associated with new medications or surgeries.

Participation in this training does not involve taking new medicine or undergoing medical procedures. It focuses on learning and providing support. No harmful effects have been reported from this type of training. It enhances providers' ability to understand and assist families dealing with these experiences.

Because this study centers on training and discussion, it is considered very low-risk. The goal is to improve communication between providers and families to support children's health. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to enhance conversations about Adverse Childhood Experiences (ACEs) during child development check-ups. Unlike standard care, which focuses on general medical procedures, the intervention trains providers to screen and discuss ACEs, potentially improving how families understand and manage the impact of these experiences. By targeting the emotional and psychological aspects of caregiving, this approach could lead to more comprehensive care for children and their families, ultimately fostering better long-term health outcomes.

What evidence suggests that this training is effective for improving child health?

Research has shown that training healthcare providers to screen for and discuss Adverse Childhood Experiences (ACEs) can lead to better health outcomes. In this trial, some providers will receive training for ACEs screening and discussion, which may help them more easily identify issues affecting a child's well-being. Studies have linked this method to reducing problems like bullying and victimization. By addressing these early experiences, healthcare providers may help decrease emergency room visits and missed appointments, leading to better overall child health. The connection between ACEs and health problems in adulthood suggests that early intervention could improve long-term health. Meanwhile, providers in the standard of care arm will receive training on study procedures without ACEs training, focusing on obtaining and storing survey instruments. ^{1 6 7 8 9}

Who Is on the Research Team?

Abigail Lott, PhD, ABPP

Principal Investigator

Emory University

Are You a Good Fit for This Trial?

This study is for caregivers bringing children to specific well-child checkups (4, 6, 9, 15, or 18 months) at the MCC. Participants should be able to speak and read English or Spanish fluently. Caregivers under age 18 or previously enrolled with another child are excluded.

Inclusion Criteria

I am bilingual as per Emory's Spanish fluency tests.

I am of Hispanic origin and primarily speak Spanish.

Caregivers will be eligible to enroll in the study if they bring children to the MCC for either a 4-month, 6-month, 9-month, 15-month, or 18-month WCC

Exclusion Criteria

I am over 18 years old.

Caregivers will be excluded if they have already been enrolled in the study protocol via another child or prior WCC

I can speak and read either English or Spanish.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Intervention

Caregivers undergo ACEs screening and participate in provider-led discussions during well-child visits

18 months

Multiple visits (in-person) at 4, 6, 9, 15, and 18 months

Follow-up

Participants are monitored for changes in child health outcomes and caregiver resilience

18 months

Follow-up assessments at 1 week, 6 months, and 18 months

What Are the Treatments Tested in This Trial?

Interventions

• Training for ACEs and study procedures
• Training on study procedures

Trial Overview The trial tests if caregiver training on Adverse Childhood Experiences (ACEs) can reduce their children's emergency visits and missed appointments by increasing awareness of ACEs' impact on child health.

How Is the Trial Designed?

Group I: Intervention Arm Experimental Treatment 1 Intervention

Intervention providers will undergo training for ACEs screening and discussion. Eligible families will be enrolled into the study at the intake of their child's 4-month, 6-month, 9-month, 15-month, or 18-month well child check. Caregivers will complete the intake surveys including demographics, caregiver ACEs, resilience, warmth, PTSD, and depression. The providers will lead a discussion regarding the impact of caregiver ACEs. Patients will be contacted 1-week, 6-months, and 18-months following their enrollment to obtain repeat measures of the survey instruments. At the 18-month time point, the electronic medical record (EMR) will be queried to obtain outcome measures.

Group II: Standard of Care Arm Active Control 1 Intervention

During the study period, standard of care providers will continue to provide standard of care treatment(s); however, families receiving care from the standard of care providers will complete all study surveys. Instead of ACEs training, standard of care providers will undergo training on study procedures including obtaining survey instruments from caregivers and proper storage of survey instruments. This training will stress the importance of not reviewing caregiver ACE scores and minimizing possible treatment contamination. However, standard of care providers will still be able to provide resources to the families as part of standard of care.

Who Is Running the Clinical Trial?

Emory University

Lead Sponsor

Trials

1,735

Recruited

2,605,000+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10725064/

The effect of adverse childhood experience training, screening ... One qualitative study found that providers were more confident with a structured ACEs screener, though they were still concerned with false positives. Three ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S0145213424002540

Adverse childhood experiences (ACEs), resilience, and ... Previous research has demonstrated a dose-response relationship between exposure to adverse childhood experiences (ACEs) and adverse outcomes in adulthood.

3. samhsa.gov samhsa.gov/sites/default/files/sptac-effective-strategies-prevent-address-adverse-childhood-experiences.pdf

Effective Strategies to Prevent and Address Adverse ... Results indicate significant reductions in bullying and victimization among program participants, supported by data from randomized controlled trials and pre- ...

4. publications.aap.org publications.aap.org/pediatrics/article/154/6/e2024067307/199824/Screening-for-Adverse-Childhood-Experiences-A

Screening for Adverse Childhood Experiences: A Critical ... ACEs include multiple aspects of a child's environment that can undermine their sense of safety, stability, and bonding, such as experiencing ...

5. acesaware.org acesaware.org/wp-content/uploads/2021/07/ACEs-Aware-Practice-Paper-WYS-and-MRC-6.28.21.pdf

Adverse Childhood Experiences and Related Life Events: Adverse Childhood Experiences (ACEs) are stressful events occurring in an individual's first 18 years of life that can result in chronic toxic stress ...

6. childhealthdata.org childhealthdata.org/docs/default-source/cahmi/aces-resource-packet_all-pages_12_06-16112336f3c0266255aab2ff00001023b1.pdf

Adverse Childhood Experiences (ACEs) Basics Adverse Childhood Experiences (ACEs) are events that cause stress, trauma, and chronic stress, impacting a child's brain and linked to negative ...

7. cdc.gov cdc.gov/aces/about/index.html

About Adverse Childhood Experiences This page defines adverse childhood experiences, presents the latest data, and describes outcomes.

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9908787/

Examining the Effects of Adverse Childhood Experiences ... The current study examines the effects of ACEs on trauma-informed intervention outcomes based on the ARC framework in a large community-based ...

9. acesaware.org acesaware.org/

Home | ACEs Aware – Take action. Save lives. The ACEs Aware initiative is a first-in-the nation effort to screen patients for Adverse Childhood Experiences (ACEs) to help improve and save lives.