Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA.
Lucile Packard Children's Hospital Stanford, Palo Alto, CA, 94304, USA.
Matern Child Health J. 2022 Mar;26(3):461-468. doi: 10.1007/s10995-021-03328-8. Epub 2022 Jan 11.
Adverse Childhood Experiences (ACEs) are traumatic events that occur before 18 years. ACEs, associated with increased health-risk behaviors and chronic health disorders, disproportionately impact people from marginalized communities. Evidence shows that toxic stress from ACEs and adverse social determinants of health can be prevented and treated with trauma-informed care (TIC). The purpose of this educational program was to train a maternal and child health workforce to bring evidence-based trauma-informed care to all impacted people.
Participants were professionals recruited from Federally Qualified Health Centers, community behavioral health organizations, educational institutions, and agencies serving low-income children and families. 100 unique participants representing 3 counties and 54 agencies joined sessions. Twelve virtual educational sessions were convened over 6 months using the Project ECHO® model via Zoom technology. Sessions consisted of didactic lectures and case-based discussions.
After completion of the series, participants reported high satisfaction and increased knowledge and confidence in using TIC best practice skills. After participation, a significant number of participants voluntarily completed an additional online training about the specific TIC best practices that had been taught in the ECHO. Participants rated the opportunity for interprofessional collaboration and peer support for vicarious trauma as program strengths.
This project demonstrated feasibility and effectiveness in delivery of a curriculum on trauma-informed care to cross-sector, multi-agency maternal and child health workforce professionals using the Project ECHO® model. Robust interprofessional collaboration and participants' request for more sessions demonstrate the potential for this model to effect change at a local systems level.
不良儿童经历（ACEs）是指 18 岁之前发生的创伤性事件。ACEs 与增加的健康风险行为和慢性健康障碍有关，对来自边缘化社区的人影响更大。有证据表明，ACEs 带来的毒性压力和健康的不利社会决定因素可以通过创伤知情护理（TIC）来预防和治疗。本教育计划的目的是培训母婴保健工作者，为所有受影响的人提供基于证据的创伤知情护理。
参与者是从联邦合格的健康中心、社区行为健康组织、教育机构和为低收入儿童和家庭服务的机构招募的专业人员。代表 3 个县和 54 个机构的 100 名独特参与者参加了会议。使用 Zoom 技术通过 ECHO 项目进行了 12 次虚拟教育会议，历时 6 个月。会议包括讲座和基于案例的讨论。
在完成系列课程后，参与者报告满意度高，在使用 TIC 最佳实践技能方面的知识和信心增强。参与后，许多参与者自愿完成了关于 ECHO 中教授的特定 TIC 最佳实践的额外在线培训。参与者对跨专业合作和同伴支持代际创伤的机会评价为项目优势。
该项目使用 ECHO 模式向跨部门、多机构母婴保健工作者专业人员提供创伤知情护理课程，展示了可行性和有效性。强大的跨专业合作和参与者对更多课程的要求表明，该模式有可能在地方系统层面产生变革。
