Evaluation of an Embedded Health Psychologist Intervention for Obstetric Patients With Adverse Childhood Experiences.
Perm J
; 28(3): 144-151, 2024 09 16.
Article
em En
| MEDLINE
| ID: mdl-38980765
ABSTRACT
BACKGROUND:
Screening for adverse childhood experiences (ACEs) and resilience in pregnancy is a promising practice for mitigating ACEs-related health complications. Yet, the best follow-up for pregnant patients with high ACEs and/or low resilience has not been established.OBJECTIVE:
This study evaluates referrals to and participation in an embedded health psychologist (EHP) intervention for pregnant patients with ACEs and/or low resilience. MATERIALS ANDMETHODS:
Patients in 3 Kaiser Permanente Northern California medical centers with ACEs who had also received resilience screening during standard prenatal care and who were participating in an EHP intervention were included (N = 910). The authors used multivariable logistic regression to examine whether ACEs (0, 1-2, 3+) and resilience (high vs low) were associated with referrals to and participation in EHP intervention. They also evaluated the impact of EHP intervention through clinician (N = 53) and patient (N = 51) surveys.RESULTS:
Patients with 3+ vs 0 ACEs were more likely to receive an EHP referral (adjusted odds ratio [aOR] = 2.89, 95% confidence interval [CI] 1.93-4.33) and were more likely to participate in EHP intervention (aOR = 2.85, 95% CI 1.87-4.36). Those with low vs high resilience were also more likely to receive an EHP referral (aOR = 1.86, 95% CI 1.32-2.62) and participate in EHP (aOR = 1.71, 95% CI 1.19-2.44). When ACEs and resilience were combined, those with high ACEs and low resilience had the greatest odds of referrals and participation. Patients and clinicians reported positive experiences with EHP intervention.CONCLUSION:
Patients with higher ACEs and lower resilience scores were more likely to be referred to and participate in EHP intervention, suggesting that at-risk patients can be successfully linked with a health psychologist when accessible within obstetric care.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
/
Resiliência Psicológica
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Experiências Adversas da Infância
Limite:
Adult
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Female
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Humans
/
Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article