RESUMEN
BACKGROUND: Adverse childhood experiences (ACEs) are traumatic childhood events that alter biopsychological markers of the human body, causing significant damaging lifelong effects and increasing health risk behavior, including substance use disorder (SUD). OBJECTIVE: This project evaluated an ACE screening tool in medication-assisted treatment (MAT) patients at a federally qualified healthcare center (FQHC) via a handheld patient tablet. METHODS: All MAT patients received the 10-question Kaiser Permanente ACE screening tool; 192 patients (N) (98 men and 94 women) completed the ACE screening. Age and gender demographics were collected. Pre- and post-ACE screening behavioral health (BH) referral rates were measured utilizing electronic health record (EHR) reports. After 3 months, post-ACE screening BH referral rates were compared to pre-ACE screening rates from the same 3 months of the previous year. RESULTS: Post-ACE screening increased BH referrals by 29.76%, a statistically significant finding (z < .00001). CONCLUSION: Screening for ACEs in MAT clinics is an effective trauma-informed intervention to increase BH referrals. IMPLICATIONS FOR NURSING: Using technology to incorporate ACE screening in MAT is feasible and provides a deeper understanding of a patient's mental health and trauma history.
RESUMEN
BACKGROUND: Physical activity (PA) is a primary factor in reducing the risk of chronic diseases, yet only half of U.S. adults meet recommended levels. OBJECTIVE: To evaluate a PA self-monitoring pilot intervention using technology in obese adult primary care patients. METHODS: The project had a prospective, single group, pretest/posttest design using an accelerometer with a smartphone app. Obese adult primary care patients (N = 31) were followed over 6 months. Demographic (age, race, sex, marital status, educational level) and PA-relevant (PA, body mass index [BMI], self-efficacy for exercise [SEE]) data were collected at enrollment. PA and BMI were recorded monthly for 6 months. SEE was reassessed at 6 months. RESULTS: PA and BMI showed gradual improvement; however, changes in PA (p = .130), BMI (p = .326), and SEE (p = .877) at 6 months were not statistically significant. A strong, negative relationship was found between PA and BMI (r = -.727, p < .01). Anecdotal data indicated the smartphone app was acceptable to patients. CONCLUSIONS: Data-supported clinician-initiated PA self-monitoring with a smartphone app was acceptable and showed favorable trends in improving PA and BMI in obese adult patients. IMPLICATIONS FOR NURSING: Prescribing PA self-monitoring using technology may be easily implemented.
