Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis
Introduction Socially excluded populations, defined by homelessness, substance use disorder, sex work or criminal justice system contact, experience profound health inequity compared with the general population. Cumulative exposure to adverse childhood experiences (ACEs), including neglect, abuse an...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e074314.full |
| _version_ | 1797640407735074816 |
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| author | Rohan Borschmann Stuart A Kinner Lindsay A Pearce Jesse Young Melissa Willoughby Alexander Charles Campbell Andrew Bruun Jacqui Sundbery |
| author_facet | Rohan Borschmann Stuart A Kinner Lindsay A Pearce Jesse Young Melissa Willoughby Alexander Charles Campbell Andrew Bruun Jacqui Sundbery |
| author_sort | Rohan Borschmann |
| collection | DOAJ |
| description | Introduction Socially excluded populations, defined by homelessness, substance use disorder, sex work or criminal justice system contact, experience profound health inequity compared with the general population. Cumulative exposure to adverse childhood experiences (ACEs), including neglect, abuse and household dysfunction before age 18, has been found to be independently associated with both an increased risk of social exclusion and adverse health and mortality outcomes in adulthood.Despite this, the impact of ACEs on health and mortality within socially excluded populations is poorly understood.Methods and analysis We will search MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Educational Resources Information Center, PsycINFO, Applied Social Science Index and Abstracts and Criminal Justice Database for peer-reviewed studies measuring ACEs and their impact on health and mortality in socially excluded populations.Three review questions will guide our data extraction and analysis. First, what is the prevalence of ACEs among people experiencing social exclusion in included studies? Second, what is the relationship between ACEs and health and mortality outcomes among people experiencing social exclusion? Does resilience modify the strength of association between ACEs and health outcomes among people experiencing social exclusion?We will meta-analyse the relationship between ACE exposure and health outcomes classified into six a prior categories: (1) substance use disorders; (2) sexual and reproductive health; (3) communicable diseases; (4) mental illness; (5) non-communicable diseases and (6) violence victimisation, perpetration and injury. If there are insufficient studies for meta-analysis, we will conduct a narrative synthesis. Study quality will be assessed using the MethodologicAl STandards for Epidemiological Research scale.Ethics and dissemination Our findings will be disseminated in a peer-reviewed journal, in presentations at academic conferences and in a brief report for policy makers and service providers. We do not require ethics approval as this review will use data that have been previously published.PROSPERO registration number CRD42022357565. |
| first_indexed | 2024-03-11T13:31:19Z |
| format | Article |
| id | doaj.art-610c352b8cdc42c9a7106560e8f18b3b |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T13:31:19Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-610c352b8cdc42c9a7106560e8f18b3b2023-11-02T18:30:08ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2023-074314Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysisRohan Borschmann0Stuart A Kinner1Lindsay A Pearce2Jesse Young3Melissa Willoughby4Alexander Charles Campbell5Andrew Bruun6Jacqui Sundbery7Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Victoria, AustraliaMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaSchool of Population Health, Curtin University, Perth, Western Australia, AustraliaMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaMelbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, AustraliaYouth Support and Advocacy Service, Melbourne, Victoria, AustraliaYouth Support and Advocacy Service, Melbourne, Victoria, AustraliaIntroduction Socially excluded populations, defined by homelessness, substance use disorder, sex work or criminal justice system contact, experience profound health inequity compared with the general population. Cumulative exposure to adverse childhood experiences (ACEs), including neglect, abuse and household dysfunction before age 18, has been found to be independently associated with both an increased risk of social exclusion and adverse health and mortality outcomes in adulthood.Despite this, the impact of ACEs on health and mortality within socially excluded populations is poorly understood.Methods and analysis We will search MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Educational Resources Information Center, PsycINFO, Applied Social Science Index and Abstracts and Criminal Justice Database for peer-reviewed studies measuring ACEs and their impact on health and mortality in socially excluded populations.Three review questions will guide our data extraction and analysis. First, what is the prevalence of ACEs among people experiencing social exclusion in included studies? Second, what is the relationship between ACEs and health and mortality outcomes among people experiencing social exclusion? Does resilience modify the strength of association between ACEs and health outcomes among people experiencing social exclusion?We will meta-analyse the relationship between ACE exposure and health outcomes classified into six a prior categories: (1) substance use disorders; (2) sexual and reproductive health; (3) communicable diseases; (4) mental illness; (5) non-communicable diseases and (6) violence victimisation, perpetration and injury. If there are insufficient studies for meta-analysis, we will conduct a narrative synthesis. Study quality will be assessed using the MethodologicAl STandards for Epidemiological Research scale.Ethics and dissemination Our findings will be disseminated in a peer-reviewed journal, in presentations at academic conferences and in a brief report for policy makers and service providers. We do not require ethics approval as this review will use data that have been previously published.PROSPERO registration number CRD42022357565.https://bmjopen.bmj.com/content/13/10/e074314.full |
| spellingShingle | Rohan Borschmann Stuart A Kinner Lindsay A Pearce Jesse Young Melissa Willoughby Alexander Charles Campbell Andrew Bruun Jacqui Sundbery Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis BMJ Open |
| title | Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis |
| title_full | Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis |
| title_fullStr | Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis |
| title_full_unstemmed | Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis |
| title_short | Adverse childhood experiences, morbidity, mortality and resilience in socially excluded populations: protocol for a systematic review and meta-analysis |
| title_sort | adverse childhood experiences morbidity mortality and resilience in socially excluded populations protocol for a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/13/10/e074314.full |
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