Ready, Set, Go? Researcher Recommendations for Translating Findings on Adverse Childhood Experiences (ACEs) into Action

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Social Policy

Abstract

Adverse Childhood Experiences (ACEs), typically defined as maltreatment and household dysfunction, are associated with poor mental and physical health (Hughes et al., 2017). The well-established consequences of ACEs make prevention efforts critical, highlighting the need for research recommendations to shift toward ACE prevention. However, little is known about the recommendations being made or their evolution over time. Thus, we conducted a scoping review to synthesize researcher recommendations for translating findings into action. Three librarians designed a comprehensive search strategy that consisted of nine databases across disciplines. Inclusion and exclusion criteria were applied in two screening phases, title and abstract followed by full text (Figure 1). Although other aspects were coded, we only present study recommendations in this poster. Recommendations were coded by examining the end of the abstract and discussion sections. Recommendations had to be at least somewhat specific and specify the target of the action or who should act on it. As we were interested in translation of research to action, recommendations for research were not coded. Recommendations were coded as primordial/primary if they would prevent or reduce the occurrence of ACEs. We coded recommendations aimed at mitigating risk of negative outcomes or preventing worsening of ACE-related outcomes as secondary/tertiary. If researchers made both primary/primordial and secondary/tertiary recommendations, we coded the article as both. We coded articles as vague/none if there was no clear direction for next steps or no recommendation. Coding was done independently by a team of researchers. Percent agreement was used to assess inter-rater reliability, and reliability checks were conducted until 80% agreement was achieved during training. Disagreements were handled by consensus or through a co-author not involved in coding that article. Primary/primordial recommendations only were coded for 1.1% of articles, with parenting programs mentioned most often (Figure 2). The 42.1% of articles coded as secondary/tertiary most frequently mentioned screening for ACEs and trauma-informed care. Only 17.0% of articles included both types of recommendations. Lastly, 39.5% of articles were coded as vague/none. There was no indication of a trend from secondary/tertiary to primary/primordial recommendations over the last 20 years. We achieved a relatively low inter-rater reliability of 75% agreement, despite the simplicity of the coding scheme, the extensive training of raters and frequent consensus meetings, which reflects that recommendations are often vague and are too open to interpretation for translation to action. Further, recommendations are often ambiguous, with statements that imply a given intervention may be helpful, but more research is needed. Researchers should use stronger designs that will allow actionable interventions and receive more training in effectively communicating their conclusions. Many of the recommendations on ACEs focus on either ameliorating their effects or are too broad for translation to action to prevent ACEs. Only about one in eight studies recommended primordial/primary prevention strategies. This is inconsistent with the public health roots of this research, which focuses on reducing risk exposure. Now that the negative effects of ACEs are well-established, emphasis should be on primordial/primary prevention efforts to reduce ACE exposure.

Authors

• Bria Gresham, University of Minnesota - Twin Cities
  Presenting Author

• Canan Karatekin, University of Minnesota - Twin Cities
  Non-Presenting Author

• Susan Mason, University of Minnesota
  Non-Presenting Author

• Amy Riegelman, University of Minnesota
  Non-Presenting Author

• Caitlin Bakker, University of Minnesota
  Non-Presenting Author

• Shanda Hunt, University of Minnesota
  Non-Presenting Author

• Andrew Barnes, University of Minnesota - Twin Cities
  Non-Presenting Author