Funded Projects

Trauma Screening in Afghan Refugee Community

Project Year

2022

City & State

Sacramento, California

Program Name

CATCH Resident

Topic

Culturally Effective Care

Program Description

Problem Adverse childhood experiences (ACEs) are associated with negative child and adult health outcomes. Pediatric providers can play an important role in trauma-informed ACEs screening, promoting protective factors, responding with evidence-based strategies, and following-up over long term. In California, the PEARLS tool is used by Medicaid providers to screen for ACEs as part of the statewide ACEs Aware initiative. Last year, we implemented PEARLS screening at the Sacramento County Health Clinic, an FQHC pediatric clinic in Sacramento County, a region home to the largest Afghan refugee population in the US. To learn more about how ACEs screening with the PEARLS tool might be perceived in the Afghan community, we conducted interviews with members of organizations that work directly with new refugees arriving from Afghanistan at various timepoints of their resettlement. Those who participated in interviews had roles in social work, casework, child/parent education, and psychiatry, and most participants were former refugees from Afghanistan. Through these interviews, several key themes arose for us to consider when screening for ACEs in the Afghan refugee community: PEARLS questions may be difficult to comprehend from cultural and linguistic standpoint, parents may not answer questions due to fear and suspicions related to child protective services, questions related to physical symptoms of distress may be seen as more relevant, education for refugees and resettlement agency staff can help normalize the conversation around ACEs, and providers should build rapport with patients before screening for ACEs. Project Goal The goals of this CATCH project are to understand (1) the knowledge, attitudes, barriers, and facilitators to providers screening for and responding to physical and emotional distress symptoms as predictors of traumatic experiences in refugee populations, (2) the feasibility of using the Refugee Health Screener (RHS-15) to screen for physical and emotional distress symptoms in Afghan refugees, and (3) the networks of resources and mental health services available in Sacramento for refugees. Proposed Intervention We propose to conduct and analyze results of 8 focus groups with stakeholders, including 4 focus groups of Afghan refugees (2 Dari-speaking, 2 Pashto-speaking), 2 focus groups of providers, 2 focus groups of community organizations. Anticipated Outcomes After completion of the focus groups, we anticipate presenting our project findings and gathering feedback from the community in order to establish a plan of implementation of trauma-informed screening for physical and emotional distress symptoms and response for the Afghan refugee population in a primary care setting

Project Goal

To understand (1) the knowledge, attitudes, barriers, and facilitators to providers screening for and responding to physical and emotional distress symptoms as predictors of traumatic experiences in refugee populations, (2) the feasibility of using the Refugee Health Screener (RHS-15) to screen for physical and emotional distress symptoms in Afghan refugees, and (3) the networks of resources and mental health services available in Sacramento for refugees.

Project Objective 1

By December 2022, we will conduct and analyze results of 8 focus groups with stakeholders, including 4 focus groups of Afghan refugees (2 Dari-speaking, 2 Pashto-speaking), 2 focus groups of providers, 2 focus groups of community organizations.

Project Objective 2

By Mar 2023, we will present our project findings and gather feedback from the community.

Project Objective 3

By May 2023, we will establish a plan of implementation of trauma-informed screening for physical and emotional distress symptoms and response for the Afghan refugee population in a primary care setting.

AAP District

District IX

Institutional Name

UC Davis Medical Center

Contact 1

Christina Callas