According to Beck et al. (2009) and Karsten et al. (2019), people with a history of ACEs, post-traumatic stress disorder (PTSD), and childhood maltreatment, are highlighted to have increased chronic pelvic pain (CPP) and pelvic floor dysfunction. Sexual abuse, violence, and childhood maltreatment events are reported to be linked to CPP, which is associated with various diseases and dysfunctions such as dyspareunia (painful sex), vulvodynia, interstitial cystitis, gastrointestinal disorders, and endometriosis (Beck et al., 2009; Harlow et al., 2005; Harris et al., 2017; Poli-Neto et al., 2018).
The primary target audience for our program includes 50 adolescents and teenagers in Austin, Texas (ages 12-18) with at least one ACE and idiopathic CPP. Austin has a population of approximately 1,013,293 people (Austin Population, 2023). At least one quarter of the population may be susceptible to having a history of ACEs in Austin (Austin Population, 2023). Furthermore, 53% of people with CPP are reported to have four or more ACEs, which may be a predictor of the development of negative health outcomes (Krantz et al., 2019). Medical care is limited in Austin, especially lacking in ACEs and CPP simultaneously. With a strong partnership to the ACEs Mentor Program in Austin (national organization that support adolescents), our program will work to increase more recognition and awareness of ACEs, trauma, and CPP (Ryder, n.d.).
This grant project serves to improve quality of life and decrease ACEs and mental health disorders for people with CPP Austin, Texas. Encouraging communal ties among individuals has reportedly reduced stress, decreased isolation, and, in turn, reduced the risk of the development of negative health outcomes (Krantz et al., 2019). A secondary goal is to improve the quality of health information online for individuals and to improve social support for adolescents.
Public Health Framework
We will use a public health framework to address all social determinants of health with three prevention levels: Primary, secondary, and tertiary (Oral et al., 2016). The primary prevention level takes a “systems level approach” to mitigate mood disorders. Preventing mood disorders from occurring while maintaining, instigating, and encouraging the ACEs Mentor Program, to maintain relationships with other stakeholders will be imperative at this level of prevention. The secondary prevention level serves to reduce the impact of CPP and mood disorders for adolescents and young adults. Frequent screenings, at least quarterly, will occur to know if the program is on target. Lastly, the third prevention level, which best aligns with our program consists of group therapy and mindfulness classes. The main objective here is to prevent and reduce CPP, which is taxing on quality of life (Krantz et al., 2019; Oral et al., 2016).
Social-Ecological Model
While utilizing McLeroy's (1988)Social-Ecological model as a framework, the program activities will include a mix of cooking classes, group therapy, and mindfulness classes. At the individual and interpersonal level, the classes will build self-efficacy, improve mood disorders, and increase social support. At the community level, the program will strive to form ties and connections with other organizations and stakeholders to facilitate changes for adolescents who participate in this program.
SAMSHA's Principles
SAMSHA's (2014) principles of peer support, safety, and trustworthiness/transparency are of focus for this program. The intervention will follow a strengths-based approach to help people with CPP work through their trauma with the help of a cognitive therapist to prevent re-traumatization. In addition, people will receive support from their mentors, trauma-informed staff, and adolescents who are participating in the program. The employees will create and maintain a safe and trusting environment and will encourage transparency and compassion. Cognitive therapy will help guide patients toward making informed decisions and adapt better thought-processes (Charbonneau et al., 2021; Clotire et al., 2017).
For our evaluation plan, a non-experimental design with qualitative and quantitative methods will be implemented. The goal will be to see if the mental health of the adolescents improves while CPP symptoms are reduced. Overall, this trauma-informed program that is inclusive to all young teenagers of the community, should accomplish a number of aspects: Encourage a decrease in mood disorders, negate the risk for negative health behaviors, and mitigate CPP symptoms.
References
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