Ellen Goldstein, James Topitzes, Jen Birstler, Richard L. Brown
a University of Wisconsin-Madison, Department of Family Medicine, United States of America
b University of Wisconsin-Milwaukee, Helen Bader School of Social Welfare, United States of America
c University of Wisconsin-Madison, Biostatistics
d Concerto Health, United States of America
A B S T R A C T
Objective: This pilot study tests the feasibility of implementing a two-session intervention that addresses adverse
childhood experiences (ACEs), post-traumatic stress symptoms, and health risk behaviors (HRBs) among Black
primary care patients. African Americans are disproportionately exposed to stressful and traumatic events and
are at greater risk for PTSD than the general population.
Method: A prospective cohort, experimental (pre-post) design with 2 post-intervention assessments were used to
evaluate the feasibility of a motivation-based intervention for Black primary care patients with one or more
ACEs. Indicators of feasibility implementation outcomes were assessed by participant adherence to treatment;
suitability, satisfaction, and acceptability of the intervention; in addition to clinical outcomes of stress, HRBs,
and behavioral health referral acceptance.
Results: Out of 40 intervention participants, 36 completed the intervention. Of the patients with one or more
ACEs who participated in the intervention, 65% reported 4 or more ACEs and 58% had positive PTSD screens,
and nearly two-thirds of those had at least one HRB. Satisfaction with the program was high, with 94% of
participants endorsing “moderately” or “extremely” satisfied. The sample showed significant post-intervention
improvements in stress, alcohol use, risky sex, and nutrition habits. Although stress reduction continued through
2-month follow-up, unhealthy behaviors rebounded. Almost one-third of participants were connected to behavioral
health services.
Conclusions: Brief motivational treatment for ACEs is feasible in underserved primary care patients and could
help individuals develop healthier ways of coping with stress and improve health.
Addressing adverse childhood experiences and health risk behaviors among low-income, Black primary care patients: Testing feasibility of a motivation based intervention (General Hospital Psychiatry)
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