Cargando…
Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California
Adverse Childhood Experiences (ACEs) are defined as traumatic events occurring before age 18, such as maltreatment, life-threatening accidents, harsh migration experiences, or violence. Screening for ACEs includes asking questions about an individual's early exposure to these types of events. A...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459376/ https://www.ncbi.nlm.nih.gov/pubmed/36091515 http://dx.doi.org/10.3389/fpubh.2022.876769 |
_version_ | 1784786496619806720 |
---|---|
author | Pérez Jolles, Mónica Fernández, María E. Jacobs, Gabrielle De Leon, Jessenia Myrick, Leslie Aarons, Gregory A. |
author_facet | Pérez Jolles, Mónica Fernández, María E. Jacobs, Gabrielle De Leon, Jessenia Myrick, Leslie Aarons, Gregory A. |
author_sort | Pérez Jolles, Mónica |
collection | PubMed |
description | Adverse Childhood Experiences (ACEs) are defined as traumatic events occurring before age 18, such as maltreatment, life-threatening accidents, harsh migration experiences, or violence. Screening for ACEs includes asking questions about an individual's early exposure to these types of events. ACEs screenings have potential value in identifying children exposed to chronic and significant stress that produces elevated cortisol levels (i.e., toxic stress), and its associated physical and mental health conditions, such as heart disease, diabetes, depression, asthma, ADHD, anxiety, and substance dependence. However, ACEs screenings are seldom used in primary care settings. The Surgeon General of California has addressed this care gap by introducing ACEs Aware, an ACEs screening fee-for-service healthcare policy signed into law by Gov. Gavin Newsom. Since January 2020, Medi-Cal, California's Medicaid health care program, has reimbursed primary care providers for using the Pediatric ACEs and Related Life-events Screener (PEARLS) tool to screen children and adults for ACEs during wellness visits. To achieve the goals set by the ACEs Aware state policy, it is essential to develop and test implementation strategies that are informed by the values, priorities, and resources of clinical settings, healthcare professionals, and end-users. To address this need, we partnered with a system of federally qualified health centers in Southern California on a pilot study to facilitate the implementation of ACEs screenings in five community-based clinics. The health centers had broad ideas for an implementation strategy, as well as best practices to improve adoption of screenings, such as focusing on staff training to improve clinic workflow. This knowledge was incorporated into the development of an implementation strategy template, used at the outset of this study. We used the Exploration, Preparation, Implementation and Sustainment (EPIS) framework to guide the study and inform a participatory planning process called Implementation Mapping. In this paper, we describe how Implementation Mapping was used to engage diverse stakeholders and guide them through a systematic process that resulted in the development of the implementation strategy. We also detail how the EPIS framework informed each Implementation Mapping Task and provide recommendations for developing implementation strategies using EPIS and Implementation Mapping in health-care settings. |
format | Online Article Text |
id | pubmed-9459376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-94593762022-09-10 Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California Pérez Jolles, Mónica Fernández, María E. Jacobs, Gabrielle De Leon, Jessenia Myrick, Leslie Aarons, Gregory A. Front Public Health Public Health Adverse Childhood Experiences (ACEs) are defined as traumatic events occurring before age 18, such as maltreatment, life-threatening accidents, harsh migration experiences, or violence. Screening for ACEs includes asking questions about an individual's early exposure to these types of events. ACEs screenings have potential value in identifying children exposed to chronic and significant stress that produces elevated cortisol levels (i.e., toxic stress), and its associated physical and mental health conditions, such as heart disease, diabetes, depression, asthma, ADHD, anxiety, and substance dependence. However, ACEs screenings are seldom used in primary care settings. The Surgeon General of California has addressed this care gap by introducing ACEs Aware, an ACEs screening fee-for-service healthcare policy signed into law by Gov. Gavin Newsom. Since January 2020, Medi-Cal, California's Medicaid health care program, has reimbursed primary care providers for using the Pediatric ACEs and Related Life-events Screener (PEARLS) tool to screen children and adults for ACEs during wellness visits. To achieve the goals set by the ACEs Aware state policy, it is essential to develop and test implementation strategies that are informed by the values, priorities, and resources of clinical settings, healthcare professionals, and end-users. To address this need, we partnered with a system of federally qualified health centers in Southern California on a pilot study to facilitate the implementation of ACEs screenings in five community-based clinics. The health centers had broad ideas for an implementation strategy, as well as best practices to improve adoption of screenings, such as focusing on staff training to improve clinic workflow. This knowledge was incorporated into the development of an implementation strategy template, used at the outset of this study. We used the Exploration, Preparation, Implementation and Sustainment (EPIS) framework to guide the study and inform a participatory planning process called Implementation Mapping. In this paper, we describe how Implementation Mapping was used to engage diverse stakeholders and guide them through a systematic process that resulted in the development of the implementation strategy. We also detail how the EPIS framework informed each Implementation Mapping Task and provide recommendations for developing implementation strategies using EPIS and Implementation Mapping in health-care settings. Frontiers Media S.A. 2022-08-26 /pmc/articles/PMC9459376/ /pubmed/36091515 http://dx.doi.org/10.3389/fpubh.2022.876769 Text en Copyright © 2022 Pérez Jolles, Fernández, Jacobs, De Leon, Myrick and Aarons. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Public Health Pérez Jolles, Mónica Fernández, María E. Jacobs, Gabrielle De Leon, Jessenia Myrick, Leslie Aarons, Gregory A. Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title | Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title_full | Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title_fullStr | Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title_full_unstemmed | Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title_short | Using Implementation Mapping to develop protocols supporting the implementation of a state policy on screening children for Adverse Childhood Experiences in a system of health centers in inland Southern California |
title_sort | using implementation mapping to develop protocols supporting the implementation of a state policy on screening children for adverse childhood experiences in a system of health centers in inland southern california |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9459376/ https://www.ncbi.nlm.nih.gov/pubmed/36091515 http://dx.doi.org/10.3389/fpubh.2022.876769 |
work_keys_str_mv | AT perezjollesmonica usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia AT fernandezmariae usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia AT jacobsgabrielle usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia AT deleonjessenia usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia AT myrickleslie usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia AT aaronsgregorya usingimplementationmappingtodevelopprotocolssupportingtheimplementationofastatepolicyonscreeningchildrenforadversechildhoodexperiencesinasystemofhealthcentersininlandsoutherncalifornia |