Parenting Education to Improve Relational Health Through Pediatric Primary Care: A Scoping Review.

The objective of this study was to describe characteristics of effective pediatric primary care interventions that focused on parenting education about healthy parent-child relationships. A scoping review of 4 electronic databases searched for related systematic reviews published in English from January 2000 to June 2023. The full texts of 14 systematic reviews were evaluated by 2 independent reviewers and used to identify 25 unique parenting interventions of which 21 improved outcomes more than the comparison group.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology.

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Adverse Childhood Experiences and Related Events are Associated with Asthma Symptoms in Children.

Objective: To examine the association between adverse childhood experiences (ACEs) and related events and asthma symptom burden in children.

Methods: This is a cross-sectional study of baseline data from 147 participants with asthma from a cohort of children enrolled in the Pediatric ACEs Screening and Resiliency Study. Participants completed the PEdiatric ACEs and Related Life Events Screener (PEARLS) tool, a 17-item questionnaire, capturing 3 domains of childhood adversity-child maltreatment, household challenges, and social context.

The effect of adverse childhood experience training, screening, and response in primary care: a systematic review.

Background: Adverse childhood experiences (ACEs) can have harmful, long-term health effects. Although primary care providers (PCPs) could help mitigate these effects, no studies have reviewed the impacts of ACE training, screening, and response in primary care.

Methods: This systematic review searched four electronic databases (PubMed, Web of Science, APA PsycInfo, CINAHL) for peer-reviewed articles on ACE training, screening, and/or response in primary care published between Jan 1, 1998, and May 31, 2023.

Screening for adverse childhood experiences in pediatrics: A randomized trial of aggregate-level versus item-level response screening formats.

Background: While there is growing support for screening for Adverse Childhood Experiences (ACEs), rigorous evidence on the efficacy and preference of screening methods is needed.

Objective: To examine caregiver: (1) rates of disclosure of their child's exposure to ACEs using item-level response (each item can be endorsed) versus aggregate-level response (only total score reported) screening format, (2) associations between family demographic factors and disclosure by screening format, and (3) emotional reaction and experience of screening formats in a diverse, low-income pediatric population.

Methods: Caregiver participants (n = 367) were randomized to complete the Pediatric ACEs and Related Life Events Screener (PEARLS) tool, in an aggregate-level response vs item-level response format from 2016-2019.

A Caregiver-Child Intervention for Mitigating Toxic Stress ("The Resiliency Clinic"): A Pilot Study.

Introduction: Primary care-based interventions that promote nurturing caregiving relationships and early relational health may help mitigate toxic stress and promote resilience in children. This pilot study aims to: (1) describe a novel group-based, psychoeducational primary care intervention for children experiencing adverse childhood experiences (ACEs) ("The Resiliency Clinic"), (2) assess program feasibility and acceptability, and (3) explore effects on child/caregiver behavioral health.

Methods: Intervention design centered on promoting supportive caregiving, caregiver/child self-regulation and co-regulation and teaching evidence-based stress management tools.

Pediatrics adverse childhood experiences and related life events screener (PEARLS) and health in a safety-net practice.

Background: Adverse Childhood Experiences (ACEs) are associated with behavioral, mental, and clinical outcomes in children. Tools that are easy to incorporate into pediatric practice, effectively screen for adversities, and identify children at high risk for poor outcomes are lacking.

Objective: To examine the relationship between caregiver-reported child ACEs and related life events with health outcomes.

Adverse Childhood Experiences, Outcomes, and Interventions.

Adverse childhood experiences (ACEs) are stressful or traumatic events that children experience before age 18 years. Studies have linked exposure to ACEs and negative health, and developmental and behavioral outcomes. Screening in pediatric medical settings provides a clear opportunity for early detection, intervention, and treatment.

Clinic and park partnerships for childhood resilience: A prospective study of park prescriptions.

Introduction: Pediatricians need community resources for childhood stress. We examined the association of weekly park visits and resilience amongst children receiving a park prescription at a clinic for low-income families.

Materials And Methods: A prospective longitudinal clinical trial was conducted amongst children ages 7-17 at a safety-net primary care clinic with measures at zero, one and three months out.

Long-term follow-up of home mechanical ventilation in young children with spinal cord injury and neuromuscular conditions.

Objectives: To provide outcomes of two decades of experience in home ventilation of children with spinal cord injury and neuromuscular conditions.

Study Design: Data were collected through chart review and interviews on 39 children who had become ventilator-dependent before their 6th birthday; 23 children had neuromuscular diseases and 16 had spinal cord injuries.

Results: Patients required an average of 0.