Whole Child Well-Child Visits: Implementing ACEs and SDOH Screenings in Primary Care.

Adverse childhood experiences (ACEs) and social determinants of health (SDOH) negatively affect health outcomes. This program was developed to screen for ACEs and SDOH in the primary care setting in families with children 9 months to 5 years of age at well-child checks and provide interventions that support families and build resiliency. Programmatic criteria were identified, referral resources were developed, and a database was implemented, with 246 families enrolled in year 1; 56.9% of caregivers reported 1 or more ACEs for their child, 63% of caregivers reported an SDOH need, and 39.4% of caregivers reported both. The average number of ACEs was 0.94. This program was created to address ACEs and SDOH, to empower families, build resiliency, and provide buffers to mitigate and prevent ACEs. It provides a model that can be implemented in a primary care setting while providing wraparound resources, including integrated mental health resources and referrals, to measure the success of these interventions.

Statewide Breastfeeding Hotline Use Among Tennessee WIC Participants.

OBJECTIVE: To examine the use of the Tennessee Breastfeeding Hotline (TBH), a 24 h/d, 7-d/wk telephonic lactation support program, based on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation. METHODS: Self-reported quantitative data were collected during the initial call. Data collected included caller type, maternal and infant characteristics, breastfeeding (BF) status, and primary reason for contacting the TBH. RESULTS: A total of 366 participants in WIC and 1,354 participants not enrolled in WIC received services through the TBH. Significant differences existed for maternal age, race, ethnicity, infant age, preterm delivery, caller type, and exclusive BF (P < .05). Among participants in WIC, lactation professionals primarily addressed concerns related to lactation and milk expression. CONCLUSIONS AND IMPLICATIONS: The TBH is a resource to address BF concerns, particularly among women who may face barriers to seeking professional lactation advice. Special Supplemental Nutrition Program for Women, Infants, and Children agencies might consider implementing initiatives outside their standard scope of clinic practice to address participants' needs for BF support.