title: Family Adversity and Resilience Measures in Pediatric Acute Care Settings.
abstract: OBJECTIVE
  Adverse childhood experiences (ACEs) impact health across the life course. The purpose of this study was to identify caregiver ACEs, current adversity, and resilience in families seeking care in pediatric acute care settings. Study aims included identifying demographic characteristics, current adversities, and resilience measures associated with caregiver ACEs ≥4.
  
  
  METHODS
  A cross-sectional survey study design was used and a convenience sample (n = 470) recruited at emergency and urgent care settings of a large Midwest pediatric hospital system.
  
  
  METHODS
  Measures were self-reported. The original 10-item ACEs questionnaire measured caregiver past adversity. Current adversity was measured using the 10-item IHELP. The six-item Brief Resiliency Scale measured resilience, and WHO-5 Well-Being Index was used to measure depressive affect.
  
  
  RESULTS
  Compared to participants with ACEs score of 0-3 participants with ACEs ≥4 were more likely to have multiple current adversities, increased risk of depression, and lower resilience.
  
  
  CONCLUSIONS
  Caregivers using pediatric acute care settings carry a high burden of ACEs and current adversities. Caregiver ACEs are associated with current child experiences of adversity. Caregivers socioeconomic status and education level may not be an accurate indicator of a family's risks or needs. Pediatric acute care settings offer opportunities to access, intervene, and prevent childhood adversity.
authors.affiliation: Children's Mercy Kansas City, Kansas City, Missouri.|School of Nursing and Health Studies, University of Missouri Kansas City, Kansas City, Missouri.
authors.forename: Donna M
authors.initials: DM
authors.lastname: O'Malley
authors.affiliation: Children's Mercy Kansas City, Kansas City, Missouri.|School of Medicine, University of Missouri Kansas City, Kansas City, Missouri.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Randell
authors.affiliation: Children's Mercy Kansas City, Kansas City, Missouri.|School of Medicine, University of Missouri Kansas City, Kansas City, Missouri.
authors.forename: M Denise
authors.initials: MD
authors.lastname: Dowd
mesh_terms: D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004632:Emergency Medical Services; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D055500:Resilience, Psychological; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: acute care; adverse childhood experiences; pediatrics; resilience