Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine
Introduction: Childhood adversity profoundly influences health, well-being, and longevity. Prevention and interventions to mitigate its harmful effects are essential. The American College of Preventive Medicine reviewed the research literature and other professional and governmental statements about...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
|
| Series: | AJPM Focus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2773065422000372 |
| _version_ | 1797991329850982400 |
|---|---|
| author | Kevin M. Sherin, MD, MBA, MPH Audrey J. Stillerman, MD Laxmipradha Chandrasekar, MD Nils S. Went, MD David W. Niebuhr, MD, MPH, MSc |
| author_facet | Kevin M. Sherin, MD, MBA, MPH Audrey J. Stillerman, MD Laxmipradha Chandrasekar, MD Nils S. Went, MD David W. Niebuhr, MD, MPH, MSc |
| author_sort | Kevin M. Sherin, MD, MBA, MPH |
| collection | DOAJ |
| description | Introduction: Childhood adversity profoundly influences health, well-being, and longevity. Prevention and interventions to mitigate its harmful effects are essential. The American College of Preventive Medicine reviewed the research literature and other professional and governmental statements about adverse childhood experiences to support the development of evidence-based and population-focused recommendations about prevention, screening, and mitigation interventions for childhood adversity. Methods: We performed an umbrella review to find, assess and synthesize the evidence from systematic reviews focused on 3 key questions: the prevention or mitigation of the effects of adverse childhood experiences; the association of screening for adverse childhood experiences with various benefits, including health outcomes; and the effectiveness and harms of interventions in individuals with elevated adverse childhood experience scores. Adverse childhood experience‒related recommendations from 6 professional and governmental organizations were also reviewed. On the basis of these reviews, the American College of Preventive Medicine developed a position statement through consensus. Results: A total of 8 systematic reviews, including 260 studies in total, were identified and combined with adverse childhood experiences‒related recommendations from 6 professional organizations to support the American College of Preventive Medicine recommendations. The American College of Preventive Medicine offers 7 adverse childhood experiences‒related recommendations focused on screening, education/training, policy/practice, and research: 2 are evidence-based, and 5 are based on expert opinion. Notably, regarding secondary prevention of adverse childhood experiences, the American College of Preventive Medicine endorses population-level surveillance and research around childhood adversity but not adverse childhood experience screening in individual clinical encounters. Conclusions: Despite limitations in the heterogeneity and quality of the published systematic reviews, the extant literature supports the American College of Preventive Medicine recommendations. Interventions to enhance protective factors and prevent and mitigate the consequences of adverse childhood experiences and other childhood adversity are promising and require further implementation and research. |
| first_indexed | 2024-04-11T08:50:24Z |
| format | Article |
| id | doaj.art-1dd13c39cb28491dbcb2cc00bd8b9364 |
| institution | Directory Open Access Journal |
| issn | 2773-0654 |
| language | English |
| last_indexed | 2024-04-11T08:50:24Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AJPM Focus |
| spelling | doaj.art-1dd13c39cb28491dbcb2cc00bd8b93642022-12-22T04:33:35ZengElsevierAJPM Focus2773-06542022-12-0112100039Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive MedicineKevin M. Sherin, MD, MBA, MPH0Audrey J. Stillerman, MD1Laxmipradha Chandrasekar, MD2Nils S. Went, MD3David W. Niebuhr, MD, MPH, MSc4Department of Family Medicine & Rural Health, Florida State University College of Medicine, Orlando, Florida; Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida; Address correspondence to: Kevin M. Sherin, MD, MBA, MPH, Family and Community Medicine, University of Central Florida College of Medicine, 5060 Jetsail Drive, Orlando FL 32812.Department of Family and Community Medicine, School Health Centers, Office of Community Engagement and Neighborhood Health Partnerships, University of Illinois Chicago, Chicago, IllinoisFamily Medicine Residency, AdventHealth Sebring, Sebring, Florida; Clinical Operations, Clinica Mi Salud, Orlando, FloridaCollaborative Care Clinician, Clinica Mi Salud, Orlando, Florida; Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, New YorkDepartment of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MarylandIntroduction: Childhood adversity profoundly influences health, well-being, and longevity. Prevention and interventions to mitigate its harmful effects are essential. The American College of Preventive Medicine reviewed the research literature and other professional and governmental statements about adverse childhood experiences to support the development of evidence-based and population-focused recommendations about prevention, screening, and mitigation interventions for childhood adversity. Methods: We performed an umbrella review to find, assess and synthesize the evidence from systematic reviews focused on 3 key questions: the prevention or mitigation of the effects of adverse childhood experiences; the association of screening for adverse childhood experiences with various benefits, including health outcomes; and the effectiveness and harms of interventions in individuals with elevated adverse childhood experience scores. Adverse childhood experience‒related recommendations from 6 professional and governmental organizations were also reviewed. On the basis of these reviews, the American College of Preventive Medicine developed a position statement through consensus. Results: A total of 8 systematic reviews, including 260 studies in total, were identified and combined with adverse childhood experiences‒related recommendations from 6 professional organizations to support the American College of Preventive Medicine recommendations. The American College of Preventive Medicine offers 7 adverse childhood experiences‒related recommendations focused on screening, education/training, policy/practice, and research: 2 are evidence-based, and 5 are based on expert opinion. Notably, regarding secondary prevention of adverse childhood experiences, the American College of Preventive Medicine endorses population-level surveillance and research around childhood adversity but not adverse childhood experience screening in individual clinical encounters. Conclusions: Despite limitations in the heterogeneity and quality of the published systematic reviews, the extant literature supports the American College of Preventive Medicine recommendations. Interventions to enhance protective factors and prevent and mitigate the consequences of adverse childhood experiences and other childhood adversity are promising and require further implementation and research.http://www.sciencedirect.com/science/article/pii/S2773065422000372ACEschildhood adversityprotective factorsumbrella reviewprevention recommendationsposition statement |
| spellingShingle | Kevin M. Sherin, MD, MBA, MPH Audrey J. Stillerman, MD Laxmipradha Chandrasekar, MD Nils S. Went, MD David W. Niebuhr, MD, MPH, MSc Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine AJPM Focus ACEs childhood adversity protective factors umbrella review prevention recommendations position statement |
| title | Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine |
| title_full | Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine |
| title_fullStr | Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine |
| title_full_unstemmed | Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine |
| title_short | Recommendations for Population-Based Applications of the Adverse Childhood Experiences Study: Position Statement by the American College of Preventive Medicine |
| title_sort | recommendations for population based applications of the adverse childhood experiences study position statement by the american college of preventive medicine |
| topic | ACEs childhood adversity protective factors umbrella review prevention recommendations position statement |
| url | http://www.sciencedirect.com/science/article/pii/S2773065422000372 |
| work_keys_str_mv | AT kevinmsherinmdmbamph recommendationsforpopulationbasedapplicationsoftheadversechildhoodexperiencesstudypositionstatementbytheamericancollegeofpreventivemedicine AT audreyjstillermanmd recommendationsforpopulationbasedapplicationsoftheadversechildhoodexperiencesstudypositionstatementbytheamericancollegeofpreventivemedicine AT laxmipradhachandrasekarmd recommendationsforpopulationbasedapplicationsoftheadversechildhoodexperiencesstudypositionstatementbytheamericancollegeofpreventivemedicine AT nilsswentmd recommendationsforpopulationbasedapplicationsoftheadversechildhoodexperiencesstudypositionstatementbytheamericancollegeofpreventivemedicine AT davidwniebuhrmdmphmsc recommendationsforpopulationbasedapplicationsoftheadversechildhoodexperiencesstudypositionstatementbytheamericancollegeofpreventivemedicine |