Julianne Ballard, Laura Turner, and Brittany Lobo are with the Sonoma County Department of Health Services, Santa Rosa, CA. Yvette P. Cuca and Carol S. Dawson-Rose are with the School of Nursing, University of California, San Francisco.
Am J Public Health. 2022 Jun;112(S3):S298-S305. doi: 10.2105/AJPH.2022.306737.
Traumatic experiences can have significant health effects, particularly when they are experienced during childhood. Structural determinants of health including environmental disasters and limited access to mental health services and affordable housing can contribute additional stress for parents with a personal history of childhood adversity. These factors can directly affect their children, contributing to intergenerational trauma. Pregnant people and families with young children are often referred to public health nursing maternal and child home visiting (HV) programs when there are concerns about historical or evolving childhood trauma. The strict eligibility and participation requirements of existing evidence-based maternal and child HV programs can exclude families that have experienced or are experiencing childhood trauma and its effects and can limit innovation by public health nurses, a hallmark of the field. Therefore, we advocate and describe the implementation of the Trauma Informed Approach in Public Health Nursing (TIA PHN) model, which incorporates a trauma-informed approach into a traditional maternal and child HV program in 3 California counties. TIA PHN, which began enrollment in March 2021, involves public health nurses and community health workers and integrates program evaluations in pursuit of evidence-based status. (. 2022;112(S3):S298-S305. https://doi.org/10.2105/AJPH.2022.306737).
创伤性经历会对健康产生重大影响，尤其是在儿童时期经历时。健康的结构性决定因素，包括环境灾害以及获得心理健康服务和负担得起的住房的机会有限，可能会给有儿童期逆境个人史的父母带来额外的压力。这些因素会直接影响他们的孩子，导致代际创伤。当人们对历史或正在发生的儿童期创伤有担忧时，孕妇和有幼儿的家庭通常会被转介到公共卫生护理母婴家庭探访 (HV) 项目。现有的基于证据的母婴 HV 项目的严格资格和参与要求可能会将经历过或正在经历儿童期创伤及其影响的家庭排除在外，并限制公共卫生护士的创新，这是该领域的标志。因此，我们提倡并描述了在公共卫生护理中实施创伤知情方法 (TIA PHN) 模型的情况，该模型将创伤知情方法纳入了加利福尼亚州 3 个县的传统母婴 HV 项目中。TIA PHN 于 2021 年 3 月开始招生，涉及公共卫生护士和社区卫生工作者，并整合了方案评估，以追求循证地位。（2022；112(S3)：S298-S305。https://doi.org/10.2105/AJPH.2022.306737）。
