MOSAICO: Modifying and Optimizing a Screener of Adverse Immigrant Childhood Occurrences for Trauma-Informed Care (TIC) in Pediatric Settings

PROJECT SUMMARY/ABSTRACT A comprehensive understanding of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) would facilitate recognition of, and response to, signs and symptoms of trauma. While pediatricians may suspect that youth have experienced trauma, this trauma is not being captured in settings best equipped to identify and intervene to address childhood trauma, such as primary care. The objective of this proposal is to build and test a primary care trauma-informed care questionnaire (TICQ) that screens for trauma and resilience experiences (ACEs and PCEs) of youth. This study, entitled MOSAIC: Modifying and Optimizing a Screener of Adversity and Resilience in Pediatric Care, seeks to adapt, implement, and validate a TICQ by following the Patient-Reported Outcome Measurement Information System (PROMIS) qualitative item development and review process. Aim 1 Step 1 generates items through thematic analysis of focus group data, participatory ideation, and a priori identification of trauma screeners. Aim 1 Step 2 classifies (“bins”) and selects (“winnows”, pile-sorts, and ranks) items with youth and parents. Aim 1 Step 3 revises and reviews items via cognitive interviews with youth. Aim 2 pilot implements this new trauma TICQ in a pediatric primary care practice in Baltimore City. Aim 3 calibrates screening items included in the TICQ with adapted and piloted items through latent class analysis (LCA) of a large sample of youth. These research aims and career development plan provide Keith Martin, DO, MS the skills to achieve his overall career goal of becoming an independent investigator focused on trauma-informed, pediatric primary care. Dr. Martin’s training plan includes experiential learning and didactic coursework to achieve the following short-term training goals: 1) Gain expertise and understanding in the theory and clinical application of the intersection between intergenerational trauma and resilience; 2) Study and optimize screening and intervention in primary care; 3) Apply practical implementation science and clinical informatic strategies; 4) Develop skills in screening item development and construct validation; and, 5) Continue skill building in the responsible conduct of research (RCR), manuscript writing, and grant writing. Dr. Martin will receive focused mentorship and consultation from a team of experts in primary care level intervention (Dr. Perrin), early life adversity (Dr. Johnson), implementation science (Dr. Bass), psychometric analysis (Dr. Musci), and stakeholder-engaged research (Dr. Polk).The rich research environment at Johns Hopkins University will allow Dr. Martin to fulfill his research and career development plans and begin to address his long-term goal of improving the health of youth by leveraging pediatric primary care to further child well-being.