VCU news

By Mary Kate Brogan
School of Pharmacy

A new project led by a Virginia Commonwealth University professor seeks to improve children’s lifelong health by training pediatricians to provide parents with education and resources to reduce the risk of traumatic events, abuse or neglect, which can predict health risks in childhood and later in life. If researchers determine this program is effective, the program could be rolled out statewide.

The project, funded by a three-year grant from the Virginia Department of Health and the Centers for Disease Control and Prevention, aims to prevent adverse childhood experiences (ACEs), which are associated with five of the 10 leading causes of death in children. ACEs can include “experiencing violence, abuse or neglect; witnessing violence in the home or community; having a family member attempt or die by suicide; growing up in a household with substance misuse, mental health problems or instability due to parental separation or household members being in jail or prison,” according to the CDC.

Sunny Shin, Ph.D., an associate professor in the VCU School of Social Work and VCU School of Medicine’s Department of Psychiatry, will lead the project, “An Evidence-Based Approach to Prevent Adverse Childhood Experiences and Injury Threats,” in partnership with the VDH’s Injury and Violence Prevention Program. Shin’s team will train pediatricians and study the impact early interventions have on children’s health.

“ACEs is one of the leading causes of injury and death among children in our country. If this project is successful, we are proposing it to be the statewide model for preventing child maltreatment and ACEs,” said Shin, the project’s principal investigator. “This project does not stop when our research ends. It could potentially lead to major policy and program change in Virginia when it comes to primary prevention of adverse childhood experiences and injury.”

In addition to posing immediate risks to children’s health, ACEs and the stress associated with them can alter their lives in the long term, from their physical health to their psychological well-being and their brain development, Shin said. Per the CDC, preventing ACEs in children can potentially reduce the number of adults with depression by 44%; lower the risk of asthma, cancer, diabetes, heart disease, obesity, alcohol misuse and tobacco use in adulthood; improve individuals’ education and career prospects; and stop the cycle of ACEs for future generations.

The project will evaluate the effectiveness of the Safe Environment for Every Kid (SEEK) model of care —which, per the VDH, addresses “targeted risk factors for child maltreatment including parental depression, major stress, substance use, domestic violence, food insecurity and harsh punishment” — in preventing ACEs in Virginia. The model aims to strengthen families and support parents, reaching them through their existing relationships with their child’s pediatrician.

Shin and his team will collaborate with the Virginia Chapter of the American Academy of Pediatrics to train randomized groups of pediatricians in five health districts across Virginia on the SEEK model of care to help them spot warning signs in parents that, left unaddressed, could be risk factors for ACEs. The doctors can then talk with parents about their needs, educate them on healthy parenting practices and, similar to social workers, offer them resources — including childcare, transportation, social services and other assistance — that could help ease their family’s burden and reduce the risk for ACEs.

“The SEEK model includes tons of referrals to local, state, nongovernmental organization, community and even federal resources. It’s a holistic model where we are using the primary care physicians as a contact point for these caregivers and parents at risk for ACEs in the future,” said Shin, who serves as director of the Innovation in Child and Family Wellness Research Group at VCU and director of the trauma-informed social and emotional learning program Rise Above.

Over the course of three years, Shin’s team will measure and assess children’s overall health, the occurrence of ACEs, parents’ knowledge and understanding of healthy parenting practices, parents’ use of the resources referred to them and pediatricians’ knowledge, attitudes, comfort level and competency in implementing the SEEK model for ACEs prevention. They will compare the results of pediatricians using the SEEK model of care with pediatricians from a control group using the current standard of care. They hope to reach 600 families in the next three years.

“The occurrence of adverse childhood experiences is not a social worker’s problem. It’s not a medical doctor’s problem. It’s a social problem that has a very close and strong influence on public health,” Shin said. “This project that we’re working on is focused on ‘Can we prevent those ACEs from happening in families and communities in a way that prevents negative health outcomes when these children grow up and become adults themselves?’ The hope and premise of this project is to let us see if we can prevent adverse childhood experiences in Virginia using this evidence-based model.”