The authors evaluated a pilot project that addresses Adverse Childhood Experiences (ACEs) in California clinics serving farmworker communities. They examined data on patient education and screening, staff and clinic readiness for trauma-informed health care, and staff and patient experiences. Results provide evidence for the feasibility, acceptability, and positive impact of an ACE education, screening, and response model informed by farmworkers.
Authors
Glave, Cristina, Mayoral, Yoselin, Eberhart, Nicole K., Alvarado, Gabriela, Roa Contreras, Alejandro, Estrada-Darley, Ingrid, Mendel, Peter
- Division
- RAND Health Care
- Pages
- 90
- Published in
- United States
- RAND Identifier
- RR-A2152-2
- RAND Type
- report
- Rights
- RAND Corporation
- Series
- Research Reports
- Source
- https://www.rand.org/pubs/research_reports/RRA2152-2.html
Table of Contents
- Addressing Adverse Childhood Experiences in Clinics Serving California Farmworker Communities 1
- About This Report 3
- Acknowledgments 4
- Summary 5
- Key Findings 6
- Recommendations for Future Work 7
- Contents 8
- Figures and Tables 9
- Figures 9
- Tables 9
- Project Partners 10
- Introduction 11
- Background 11
- Evaluation Overview 13
- Evaluation Approach 14
- NACES Project Logic Model 14
- Structures 14
- Processes 14
- Outcomes 15
- Key Deliverable 15
- Evaluation Approach and Data Sources 17
- Clinic Intervention Context 19
- Clinic Readiness for Trauma-Informed Health Care 20
- Methods 21
- Results from Clinic Readiness for Trauma-Informed Health Care Assessment Tool 22
- Clinician and Clinical Staff Training 24
- Methods 25
- Survey Instrument 25
- Results from Clinician and Clinical Staff Trainings 28
- Pre- and Post-Analysis Results 28
- Late-Project Implementation Survey Results 32
- ACE-Related Intervention Administrative Data 33
- Methods 35
- Results from ACE-Related Intervention Data 35
- Clinician and Clinical Staff Experiences 42
- Methods 42
- Results from Clinician and Staff Interviews 44
- Training and Readiness 45
- Plans for Sustainability 49
- Impact and PatientStaff Experience 50
- Patient and Caregiver Experiences 53
- Methods 54
- Results from Caregiver and Adult Patient Interviews 56
- Interview Respondent Demographics 56
- Thematic Analysis Summary 58
- Implementation 60
- Acceptability 64
- Impact 68
- Discussion and Recommendations 72
- Summary and Discussion 73
- Clinic Readiness for Trauma-Informed Health Care 73
- Clinician and Clinical Staff Training 74
- ACE-Related Intervention Administrative Data 74
- Clinician and Clinical Staff Experiences 75
- Patient and Caregiver Experiences 75
- Limitations 77
- Recommendations 78
- Conclusion 80
- Adapted Clinic Readiness for Trauma-Informed Health Care Assessment Tool 81
- Clinician and Clinical Staff Training Survey Tool 84
- Abbreviations 89
- References 90
