Primary Care Interventions to Prevent or Treat Traumatic Stress in Childhood: A Systematic Review.
OBJECTIVE
To systematically assess the evidence base for prevention and treatment of child traumatic stress in primary care settings.


METHODS
PubMed, Embase, PsycINFO, Scopus, Academic Search Complete, CINAHL, Web of Science, Cochrane Library, the National Registry of Evidence-based Programs and Practices, the National Child Traumatic Stress Network website, Google search.


METHODS
Studies were eligible for inclusion if they described the results of intervention studies in a primary care setting addressing child traumatic stress. Study participants could include primary care providers, pediatric patients, and their parents or other caregivers.


METHODS
Each study was assessed for inclusion, and each included study was assessed for risk of bias by 2 reviewers.


RESULTS
We found 12 articles describing 10 different studies that met the inclusion criteria. The intervention approaches taken in the studies were diverse and included the implementation of screening programs or tools, training clinicians to recognize and discuss psychosocial issues with patients and their families, and providing primary care professionals with community resource lists. Nine out of 10 studies included in the review reported favorable results.


CONCLUSIONS
Studies included in the review had relatively short follow-up periods, and the diversity of studies identified precluded the possibility of conducting a meta-analysis.


CONCLUSIONS
Findings suggest that interventions in pediatric primary care settings are feasible and can favorably affect clinical practices and families' outcomes.
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Electronic address: aflynn3@jhu.edu.
Anna B
AB
Flynn
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Kate E
KE
Fothergill
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Holly C
HC
Wilcox
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
Elizabeth
E
Coleclough
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Russell
R
Horwitz
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Anne
A
Ruble
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Matthew D
MD
Burkey
Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md.
Lawrence S
LS
Wissow
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011320:Primary Health Care; D000067073:Psychological Trauma / Q000517:prevention & control* / Q000628:therapy; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control* / Q000628:therapy; D013315:Stress, Psychological / Q000517:prevention & control* / Q000628:therapy
adolescent; adverse childhood experiences (ACEs); child; child, preschool; infant; infant, newborn; posttraumatic; primary health care; primary prevention; secondary prevention; stress disorders; tertiary prevention