PHC6534 CHILDREN OF AN INCARCERATED PARENT: Applying a trauma-informed approach to mitigate the risks of poor health outcomes.

This grant proposal addresses the population of children with an incarcerated parent.  The U.S. leads internationally in the imprisonment of its citizens and incarceration per 100,000 residents from 1970-2015 has increased by > 400% in 15 to 64 year-olds.¹ The staggering disparities between non-white and white incarceration rates of U.S. citizens are multifactorial. Children of the incarcerated have a higher number of Adverse Childhood Experiences than the general population and carry an elevated risk of poor short-term and long-term health outcomes. Increasing ACE/Trauma-Informed Care (TIC) awareness of the caregivers and key organizations (medical/behavioral health, the justice system, school system, and community level through mentoring) will be the start of a trauma-informed program designed to establish protective factors for vulnerable children of incarcerated parents.

The key principles identified by SAMHSA as necessary for a trauma-informed approach- safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, and cultural, historical, and gender issues²  will be used in this project. Participants will assemble in places deemed safe by trauma-informed organizations to avoid re-traumatization during assessments, mentorship, and recreational events.³ Activities to decrease anxiety will develop coping skills to support vulnerable populations. A sense of safety will be established with consistency in organizational processes and service providers.⁴ Trustworthiness and transparency will be demonstrated in diversity among the program leadership team and service providers. There will be ongoing collaboration with county stakeholders throughout the planning process. Community participants should serve as resources to identify the community needs³.  Peer support will be available during caregiver meetings- a setting where lived experiences can be safely shared. Strategies to decrease the risk of secondary trauma will be an integral part of trauma-informed training.⁵

This project will address the five societal levels of the McElroy social-ecological model.⁶  Factors at the intrapersonal level are of particular importance to the target audience. This level considers individual cognitions regarding trauma, i.e., personal beliefs, attitudes, and values, and their effect on behavior.⁶ In the case of traumatic experiences and their effect on health outcomes, aligning intrapersonal level factors with the trauma-informed approach will produce effective interventions.  This project addresses the interpersonal level with supportive relationships⁶ not only for children through trauma-informed caregivers and mentors but also for individuals within the service organizations.   Additionally, the involvement of youth in supportive community organizations improves self-esteem and promotes health-protective behavior⁶.

The public health approach transforms the individual treatment of disease model to a preventive one delivered through the community partners to address the health risks of the target population.  A collaboration of county organizations in addition to the caregiver as a key stakeholder will meet awareness and training goals and deliver a multi-level program aimed at preventing the elevated health risks associated with children of incarcerated parents in Irwin County, GA. The multidisciplinary team will implement methods to establish an ongoing platform of communication and exchange of ideas to aid program success and sustainability in the promotion of wellness and in decreasing the risks and incidence of disease in the target population. At the primary level of prevention, federal and state legislation to close the equity gap in policing and delivery of punitive justice within the U.S. jail/prison systems would have far-reaching effects on the disproportionate rates of incarceration in impoverished communities. Building equal access to job-related training/skills may decrease the poverty rate by decreasing unemployment in affected communities. Using the Social Emotional Learning curriculum in schools is a primary prevention approach to promote healthy behavior.⁷  At the secondary prevention level the use of universal precautions (taking extra care assuming a history of trauma) during screening identifies children in the target population who need supplemental resources or referral to a specialist.  The tertiary stage of prevention includes treatment from a trauma-informed care specialist.⁷ These preventive strategies can affect short-term outcomes that impact long-term health in the target population.

1. Incarceration Trends in Georgia - state-incarceration-trends-georgia.pdf. (2021).  org. https://www.vera.org/downloads...n-trends-georgia.pdf
2. Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
3. Srivastav M, MPH, Aditi, Strompolis P, Melissa, Moseley M, Amy, Daniels B, Kelsay. The Empower Action Model: A Framework for Preventing Adverse Childhood Experiences by Promoting Health, Equity, and Well-Being Across the Life Span. Health Promotion Practice. 2019.
4. Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 1, Trauma-Informed Care: A Sociocultural Perspective. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207195/
5. Jarjoura RG, DuBois DL, Shlafer RJ, Haight KA. Mentoring Children of Incarcerated Parents. The U.S. Department of Justice, The National Institute of Corrections. https://ojjdp.ojp.gov/sites/g/...entoringCOIP2013.pdf
6. Simons-Morton E, MPH, Bruce, McElroy P, Kenneth R., Wendel D, MA, Monica L. Behavior Theory in Health Promotion Practice and Research. Jones & Bartlett Learning, LLC; 2012.
7. A Funder's Resource Guide for Supporting Trauma-Informed Practice in the Delaware Valley. (2021). The Scattergood Foundation.