Adverse Childhood Experiences, the Medical Home, and Child Well-Being.
Matern Child Health J
; 19(11): 2492-500, 2015 Nov.
Article
em En
| MEDLINE
| ID: mdl-26140833
ABSTRACT
OBJECTIVES:
To examine the relationship between adverse childhood experiences (ACE), access to a medical home and a global measure of well-being among children ages 6-17 using the 2011-2012 National Survey of Children's Health.METHODS:
Multivariate linear regressions assessed the associations between each adverse experience and an index of child well-being with and without the impact of other events. The number of ACE was summed for each respondent and the analyses were repeated with the cumulative score as a continuous variable. The cumulative model was repeated with the addition of an interaction term between ACE score and medical home access. All analyses were conducted separately for children ages 6-11 and adolescents 12-17.RESULTS:
Over half (53 %) of US children ages 6-17 have experienced some adverse experience during childhood. Over a quarter (28 %) has experienced at least two adverse experiences, while 15 % have experienced three or more hardships. Results suggest that the accumulation of ACE reduces well-being in children. The associations remained significant after controlling for gender, race/ethnicity, age, parental education, special health condition, and medical home access. Medical home access was consistently associated with higher levels of child well-being and was a significant moderator of the relationship between the total ACE and child well-being among children ages 6-11. Children with ACE exposure and access to a medical home have higher levels of well-being than comparable children without access to a medical home. CONCLUSIONS FOR PRACTICE Children exposed to adverse experiences have measurably lower levels of well-being, although younger children with access to a medical home are protected at increasing exposure.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Maus-Tratos Infantis
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Proteção da Criança
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Assistência Centrada no Paciente
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Acessibilidade aos Serviços de Saúde
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Acontecimentos que Mudam a Vida
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article