ACEs & TIROH

Adverse Childhood Experiences and Trauma-Informed Resilience-Oriented Healthcare

Adverse Childhood Experiences (ACEs) and toxic stress are public health crises. ACEs are stressful or traumatic events experienced by age eighteen, identified in the landmark Centers for Disease Control and Prevention (CDC) and Kaiser Permanente (KP) Adverse Childhood Experiences Study, to be strongly associated with increased health and social risks. Early detection and intervention can help prevent or reduce the health risks associated with ACEs.

Trauma-Informed, Resilience-Oriented Healthcare (TIROH) is an organizational culture, structure, and treatment framework built on understanding, recognizing, and responding to all kinds of trauma and places focus on protective, resilience-oriented approaches to the entire organization. Adopting TIROH practices can improve patient engagement, treatment adherence, and health outcomes, as well as provider and staff wellness.

CAFP’s Commitment to ACEs & TIROH

CAFP is deeply committed to the work of TIROH. Our 2022-2024 strategic plan goals and educational activities are testament to our understanding that family physicians need to learn about the profound impact of ACEs and toxic stress on health. As more family physicians include ACEs and TIROH in their regular clinical routines, more patients and their families will benefit.

The third of our four Strategic Goals is Prioritize Justice Through Diversity, Equity and Inclusion. While many of the objectives and strategies under this goal relate to TIROH, the most relevant is objective 3.6, Apply a Trauma-informed Lens in All Our Work. Strategies under 3.6 include, Educate members about the components of trauma-informed care (TIC) and Identify TIC goals and components of applying a trauma
informed lens.

We aim to educate and transform both our 10,000+ physician members and ourselves –the staff of CAFP – in order to best incorporate TIROH principles throughout the fabric of CAFP.

ACEs Practice Inquiry Groups: Beyond Screening

Join a CAFP’s ACEs Practice Inquiry Group!

A collaborative, case-based virtual experience where you’ll learn more about incorporating ACEs and toxic stress work into your practice. Led by a trained ACEs Champion facilitator, we’ll gather online with colleagues to analyze cases, compare screening implementation strategies, share best practices, strategize on staff training and discuss barriers. The emphasis will be on moving from theory to practice, with a special focus on the unique aspects of family medicine.

Our goals include helping you:

  • Build confidence and expertise in addressing ACEs and toxic stress with your patients, regardless of ACEs score;
  • Identify strategies that may improve your and your patients awareness of ACEs and toxic stress; and
  • Select specific strategies to apply in your own clinical setting to better address ACEs and toxic stress.

Register for one of the three PI Groups below. While we’ve divided groups by region, it’s not a strict division – register for the date that works for you.

  • Thursday, February 15, 6:30-8:30pm – Northern California
  • Thursday, February 29, 6:30-8:30pm – Central California
  • Thursday, March 14, 6:30-8:30pm - Southern California
Register Here

For more information contact Laurie Isenberg, Lisenberg@familydocs.org

ACEs Aware Provider Engagement Pilot Program

CAFP deepens our work through a partnership with the UCLA-UCSF ACEs Aware Family Resilience Network (UCAAN). Our shared goal is significant growth in ACEs-TIROH awareness throughout California family medicine. This is achieved through a multi-pronged approach including live presentations and workshops, practice inquiry groups, magazine articles, online discussion groups, and more.

ACEs, Toxic Stress and Patient Education: A Performance Improvement Project

This Performance Improvement project was launched in 2023 and has been refreshed and relaunched for 2024. It is designed to improve patient and physician ACEs awareness and patient education, and to study the impact of educational materials on patients’ understanding of ACEs’ health impacts. Participating physicians survey patients, distribute educational materials, analyze survey data, and reflect on resulting practice improvement.

Results from 2023 indicated that raising awareness of ACEs and toxic stress did not significantly burden physicians and increased patient understanding of ACEs as a healthcare issue.
2023 ABFM PI ReportMore Information

Family Medicine Initiative on Trauma-Informed Care (FIT)

This peer-to-peer learning initiative was funded by the Office of the California Surgeon General, the Department of Health Care services, and ACES Aware. Now concluded, it raised awareness about Adverse Childhood Experiences (ACEs).

CAFP organized a series of regionally-based, peer-to-peer learning workshops concerning ACEs screening rationale and methods, followed by peer-to-peer discussion groups on best practices, overcoming barriers to care, and practice approaches for this new screening tool. Participants addressed trauma-informed communication techniques, building a patient’s resiliency, and a trauma-informed physical exam.
ACEs Screening FAQ

Education On-Demand

Activities available 24/7 include:

  • Key Insights into a Trauma-Informed Approach to Care
  • From Trauma to Healing: For Our Patients, Our Communities, and Ourselves
  • Fundamentals of Adverse Childhood Experiences (ACEs) Screening and Response

TEDTalk: Nadine Burke Harris

How childhood trauma affects health across a lifetime

Childhood trauma isn’t something you just get over as you grow up. Pediatrician Nadine Burke Harris, former Surgeon General of California, explains that the repeated stress of abuse, neglect and parents struggling with mental health or substance abuse issues has real, tangible effects on the development of the brain. This unfolds across a lifetime, to the point where those who’ve experienced high levels of trauma are at triple the risk for heart disease and lung cancer. An impassioned plea for pediatric medicine to confront the prevention and treatment of trauma, head-on.

Watch Here

More Training

Access ACEs Aware training and self-attestation to certify physicians for MediCal payment.
LEARN MORE

ACEs Resources

Resources to help support your trauma-informed family practice.
FIND RESOURCES

Connect with your local CAFP chapter

Find fellow family physicians in your neighborhood.
MEET YOUR LOCAL CHAPTER
cafp@familydocs.org
(415) 345-8667
816 21st Street, Sacramento, CA 95811
© 2019-2022 California Academy of Family Physicians. All Rights Reserved.
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