PHC 6534: Addressing Adverse Childhood Experiences to reduce Asthmatic Episodes and the risk of Asthma in Children

Public Health Framework

As stated in the Trauma-Informed Philanthropy guide, the field of public health takes an upstream approach to addressing health concerns with and community and or population⁹. Using a public health framework allows you to impact a population by focusing on a wider range of ways to address health and increase sustainability overall. With the use of multi-level programming, it will aid in bringing about systems change with policy, programming, and cross-cutting themes. The addition of multiple partners within an intervention helps address those social determinants of health and broaden expertise on certain topics important to the proposed intervention like economic stability and built environment.

This project will utilize two stages of prevention, primary and secondary in a multi-level approach⁹. As stated above using primary prevention, which helps to prevent the disease or injury before it occurs, will aim to decrease the occurrence asthmatic episodes, and decrease the risk of getting asthma by addressing ACEs and the stress that can be brought on due to certain traumas through education. The next aim will be using secondary prevention, by first using the ACEs survey to determine the level of trauma and then move on to screening if there is a concern of brain development issues. Continuing the secondary prevention efforts will include, observing the home environment and discussing economic stability to provide the necessary resources to lighten the burden, reduce stress and provide a safer and healthier place for children that have a risk of asthma or regular asthmatic episodes to live.

Levels of Social Ecological Models

This project will focus on using the McLeroy Model and components of this social ecological model¹⁰. Starting with the intrapersonal level of the social ecological model which will provide ACEs surveys and CT scans to each child in the program and create a plan for each child based on the level of trauma they have experienced. The next level is the interpersonal level in which the intervention will focus on informing caregivers like the parents or other peers about how ACEs can affect a child’s asthma or increase the chances that a child will develop asthmatic conditions. Lastly this project will address the Organizational level, this is the largest focused level of the social ecological model¹⁰. This level will address neighborhood and built environment that the child and their family reside in, and economic stability with home assessments to help create a safe and healthy environment for children affected by asthma and provide the family with adequate resources financially.

Focus and support groups will not only educate the child on asthma and coping mechanisms addressing their traumas but also provide parents with a safe space to talk about their concerns and what could be affecting them in terms of providing a safe space for the child. These levels were chosen because changes in the social environment will encourage change in individuals and with the support of the health partners, social workers, and other outside organizations environmental changes can be implemented.

Trauma-Informed Principles

The Trauma informed principles that I will focusing on is Peer support and mutual self-help¹¹. This principle focuses on programming that can be created to teach a population through the lived experiences of individuals conducting things like support groups and focus groups¹⁰. It is important to understand that some participants in a program may not feel comfortable sharing their experiences with others so developing ways to get participants to open up, will be key in making sure that the peer and support groups are effective for participants. The second Trauma informed principal that I will be analyzing is Cultural, historical and gender issues. Although this project does not focus primarily on a specific race or gender, it does focus on social determinants of health being neighborhood and built environment and economic stability. Many people in the United States live in neighborhoods that have unsafe air or water, and other health risk that can affect asthmatic and breathing conditions. Racial/ethnic minorities and people with low incomes are more likely to live in places with these risks³.

Using this principal will allow this program to provide services that are culturally sensitive like providers and partners being aware of other cultures and not assuming due to lack of familiarity, building trust and rapport with children and families, active listening to program participants situation and their needs and connect participants to appropriate resources where necessary¹⁰. The Trauma informed principles will utilize cross-sector collaboration by working with providers like pediatricians, lung and pulmonary doctors, and social workers to promote trauma-informed practices and address the needs of the children who are the more vulnerable population and the parents of children in the community with asthma conditions¹⁰. Also addressing the physical environment in which most program activities will take place, being the hospital is a safe space that is monitored by security and other personnel that have been properly vetted. In addition to hospital safety, it is important to have a psychologically safe environment by placing emphasis on the idea that no participant will be punished or humiliated for speaking up on a topic, concern, or if they have made a mistake, all groups will be inclusive and non-judgmental. Focus and support groups will be conducted in areas that are private and a safe space for sensitive topics and discussions.