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Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit.

ABSTRACT: Objectives:Adverse childhood experiences (ACE) are associated with poor short, medium and long-term health outcomes. South Western Sydney (SWS) has a large culturally diverse population, including many disadvantaged population groups. Our aims were to determine the burden of ACE in children attending community paediatric (CP) clinics using a purposefully developed ACE checklist, and explore any association with developmental health of children. Methods:We trialled the ACE checklist in all CP clinics including child development (CD) and vulnerable child (VC) clinics between February 2017 and August 2017. Data were collated from completed ACE checklists and relevant clinical information from CP clinics. Statistical analysis was performed using SPSS and MedCalc software. Results:Of 279 children seen in CP clinics with checklists completed for the period, 167 (60%) attended CD clinics and 112 (40%) attended VC clinics. Seventy-eight (28%) had ACE ?4?and 178 (64%) had ACE ?1. Of those attending CD clinics, 8 (5%) had ACE ?4 compared with 70 (63%) attending VC clinics (p<0.001). Of all age groups, children ?10 years of age had the highest proportion of children with ACE ?4 (65%); significant association between age group and ACE ?4 (p<0.001). There was a significant association between cultural background and ACE ?4 (p<0.001); indigenous children had the highest proportion of ACE ?4 (n=21; 64%), followed by Anglo-Australian children (55%). On logistic regression analysis, only attending VC clinics was significantly associated with ACE ?4. There was no significant association between ACE ?4?and developmental health. Conclusion:Among children attending CP clinics in SWS, more than a quarter had a significant burden of ACE; those attending specialised clinics for vulnerable children, those from particular ethnic groups and from older age groups, had the highest burden of ACE. Our findings support the need for specialised pathways for paediatric assessment for vulnerable, at-risk children.

SUBMITTER: Wickramasinghe YM

PROVIDER: S-EPMC6422242 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit.

Wickramasinghe Yuanee Mary YM Raman Shanti S Garg Pankaj P Hurwitz Romy R

BMJ paediatrics open 20190308 1

<h4>Objectives</h4>Adverse childhood experiences (ACE) are associated with poor short, medium and long-term health outcomes. South Western Sydney (SWS) has a large culturally diverse population, including many disadvantaged population groups. Our aims were to determine the burden of ACE in children attending community paediatric (CP) clinics using a purposefully developed ACE checklist, and explore any association with developmental health of children.<h4>Methods</h4>We trialled the ACE checklis ...[more]

PMID: 30957023

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Project description:IntroductionHIV diagnoses among gay and bisexual men have increased over the past decade in Australia. HIV point-of-care testing (POCT) was introduced in Australia in 2011 as a strategy to increase HIV testing by making the testing process more convenient. We surveyed gay and bisexual men undergoing POCT to assess barriers to HIV testing and characteristics associated with not having previously tested for HIV (never testing).MethodsDuring 2011 and 2012, gay and bisexual men who were undergoing POCT at four Sydney sexual health clinics self-completed questionnaires assessing testing history and psychological and structural barriers to HIV testing. Bivariate and multivariate logistic regression was used to assess associations between patient characteristics and never testing.ResultsOf 1093 participants, 981 (89.9%) reported ever testing for HIV and 110 (10.1%) never testing. At least one barrier to testing was reported by 1046 men (95.7%), with only 47 men (4.3%) not reporting any barrier to testing. The most commonly reported barriers to testing were annoyance at having to return for results (30.2%), not having done anything risky (29.6%), stress in waiting for results (28.4%), being afraid of testing positive (27.5%) and having tested recently (23.2%). Never testing was independently associated with being non-gay-identified (adjusted odds ratio [AOR]: 1.9; 95% confidence interval [CI]: 1.1-3.2), being aged less than 25 years (AOR: 2.4; 95% CI: 1.6-3.8), living in a suburb with few gay couples (AOR: 1.9; 95% CI: 1.2-3.0), being afraid of testing HIV-positive (AOR: 1.6; 95% CI: 1.0-2.4), not knowing where to test (AOR: 3.8; 95% CI: 1.3-11.2) and reporting one or no sexual partners in the last six months (AOR: 2.7; 95% CI: 1.2-6.2).ConclusionsBarriers to HIV testing were commonly reported among the clinic-based gay and bisexual men in this study. Our findings suggest further health promotion and prevention strategies are needed to address the knowledge, attitudes and behavioural factors associated with never testing.

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Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit.

Publications

Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit.

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