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

PROJECT SUMMARY/ABSTRACT Immigration-related trauma, including deportation, detention, and discrimination upon arrival, is detrimental to the health and well-being of children in immigrant families (CIF). Latinx people in the United States (US) experience high rates of such trauma. A comprehensive understanding of adverse childhood experiences

(ACEs) among Latinx CIF experiencing immigration-related trauma would facilitate recognition of and response to signs and symptoms of trauma. While pediatricians may suspect that CIF 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 the unique traumatic experiences (ACEs) of Latinx children in immigrant families. This study, entitled MOSAICO: Modifying and Optimizing a Screener of Adverse Immigrant Childhood

Occurrences for Trauma-Informed Care (TIC) in Pediatric Settings, seeks to adapt, implement, and validate a TICQ for Latinx CIF 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 Latinx CIF and Latinx parents. Aim 1 Step 3 revises and reviews items via cognitive interviews with Latinx CIF. Aim 2 pilot implements this new trauma

TICQ in a pediatric primary care practice in Baltimore City that primarily serves Latinx CIF. Aim 3 calibrates screening items included in the TICQ with adapted and piloted items through confirmatory factor analysis (CFA) of a large sample of Latinx CIF. 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 TIC of CIF in 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 migration and trauma; 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 re-search (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 health disparities among Latinx CIF (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 CIF by leveraging pediatric primary care to further child well-being.