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Evaluation of an Embedded Health Psychologist Intervention for Obstetric Patients With Adverse Childhood Experiences.
Watson, Carey R; Wei, Julia; Rios, Normelena; Staunton, Mary; Koper, Anna; Shiels, Jacqueline; Lee, Nina; Young-Wolff, Kelly C.
Afiliación
  • Watson CR; Obstetrics and Gynecology, Kaiser Permanente, Antioch Medical Center, Antioch, CA, USA.
  • Wei J; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA.
  • Rios N; Obstetrics and Gynecology, Kaiser Permanente Dublin Medical Offices, Dublin, CA, USA.
  • Staunton M; Department of Psychiatry, Kaiser Permanente, Walnut Creek Medical Center, Walnut Creek, CA, USA.
  • Koper A; Obstetrics and Gynecology, Kaiser Permanente Dublin Medical Offices, Dublin, CA, USA.
  • Shiels J; Obstetrics and Gynecology, Kaiser Permanente, Antioch Medical Center, Antioch, CA, USA.
  • Lee N; Obstetrics and Gynecology, Kaiser Permanente Walnut Creek Medical Center, Walnut Creek, CA, USA.
  • Young-Wolff KC; Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA.
Perm J ; 28(3): 144-151, 2024 09 16.
Article en En | MEDLINE | ID: mdl-38980765
ABSTRACT

BACKGROUND:

Screening for adverse childhood experiences (ACEs) and resilience in pregnancy is a promising practice for mitigating ACEs-related health complications. Yet, the best follow-up for pregnant patients with high ACEs and/or low resilience has not been established.

OBJECTIVE:

This study evaluates referrals to and participation in an embedded health psychologist (EHP) intervention for pregnant patients with ACEs and/or low resilience. MATERIALS AND

METHODS:

Patients in 3 Kaiser Permanente Northern California medical centers with ACEs who had also received resilience screening during standard prenatal care and who were participating in an EHP intervention were included (N = 910). The authors used multivariable logistic regression to examine whether ACEs (0, 1-2, 3+) and resilience (high vs low) were associated with referrals to and participation in EHP intervention. They also evaluated the impact of EHP intervention through clinician (N = 53) and patient (N = 51) surveys.

RESULTS:

Patients with 3+ vs 0 ACEs were more likely to receive an EHP referral (adjusted odds ratio [aOR] = 2.89, 95% confidence interval [CI] 1.93-4.33) and were more likely to participate in EHP intervention (aOR = 2.85, 95% CI 1.87-4.36). Those with low vs high resilience were also more likely to receive an EHP referral (aOR = 1.86, 95% CI 1.32-2.62) and participate in EHP (aOR = 1.71, 95% CI 1.19-2.44). When ACEs and resilience were combined, those with high ACEs and low resilience had the greatest odds of referrals and participation. Patients and clinicians reported positive experiences with EHP intervention.

CONCLUSION:

Patients with higher ACEs and lower resilience scores were more likely to be referred to and participate in EHP intervention, suggesting that at-risk patients can be successfully linked with a health psychologist when accessible within obstetric care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Resiliencia Psicológica / Experiencias Adversas de la Infancia Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: Perm J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Resiliencia Psicológica / Experiencias Adversas de la Infancia Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do norte Idioma: En Revista: Perm J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos