Department of Family Medicine and Community Health, University of Wisconsin-Madison, Madison, WI.
Institute for Child and Family Well-Being, University of Wisconsin-Milwaukee Helen Bader School of Social Welfare, Milwaukee, WI.
Perm J. 2020 Nov;24:1-9. doi: 10.7812/TPP/19.233.
Considerable evidence suggests that greater attention should be paid to the impact of trauma among low-income, racial/ethnic minority patients living in urban communities. The goal of this article is to evaluate a 2-session, motivational intervention designed to motivate a change in health risk behaviors among low-income, self-identified Black/African American patients with adverse childhood experiences (ACEs).
Qualitative self-reported data described helpful aspects of the intervention and those that could be improved. Eligible participants with 1 or more ACEs being seen in a community-based clinic were interviewed by a mental health clinician researcher for 2 in-person sessions scheduled 1 month apart. Content analysis was performed using a general inductive approach to identify core themes.
In total, 36 of 40 participants completed both sessions, with the majority reporting a high rate of satisfaction. Participants emphasized the importance of talking with a trained professional who could listen without judgment, understand patient challenges, clarify patient goals, and facilitate behavior change plans. Suggestions for improvement included modifying structure and content, enhancing clinic environment, improving linkages to behavioral health, and increasing communication and collaboration with clinicians.
Participant evaluation data gathered for this study suggest that through the practice of asking, listening, and accepting, clinicians can help patients who have been exposed to childhood adversity better understand themselves and promote healthy coping behaviors. This study provides preliminary data on the needs of underserved patients that can be utilized to develop and deliver health promotion interventions using a trauma-informed approach in community-based clinics.
大量证据表明，应更加关注生活在城市社区的低收入、少数族裔患者的创伤影响。本文的目的是评估一项针对低收入、自我认同为黑人/非裔美国患者的 2 节动机干预措施，这些患者经历过不良的童年经历（ACEs），有改变健康风险行为的动机。
定性自我报告数据描述了干预措施的有益方面和可以改进的方面。在社区诊所就诊的符合条件的 ACEs 患者接受了心理健康临床医生研究员的 2 次面对面访谈，间隔 1 个月。采用一般归纳方法进行内容分析，以确定核心主题。
共有 40 名参与者中的 36 名完成了 2 次访谈，大多数人报告满意度很高。参与者强调与接受过培训的专业人士交谈的重要性，专业人士可以倾听而不评判、理解患者的挑战、澄清患者的目标，并促进行为改变计划。改进建议包括修改结构和内容、改善诊所环境、加强与行为健康的联系，以及增加与临床医生的沟通和合作。
本研究收集的参与者评估数据表明，通过提问、倾听和接受的实践，临床医生可以帮助经历过童年逆境的患者更好地了解自己，促进健康的应对行为。本研究提供了有关服务不足患者需求的初步数据，可用于在社区诊所中采用创伤知情方法开发和提供健康促进干预措施。
