The Urban Child Institute has granted funding for 2022-2023 to projects at the University of Tennessee Health Science Center and Le Bonheur Children’s Hospital to help young children, who are coping with the effects of trauma.
The Urban Child Institute (UCI) awarded $375,000 to the UTHSC Center for Youth Advocacy and Well-Being, formerly the UTHSC Center for Health in Justice Involved Youth, to support the center’s Integrated Care for Child Wellness (ICCW) program.
The UCI also awarded $500,000 to the Family Resilience Initiative (FRI), administered through UT Le Bonheur Specialists (ULPS), a pediatric physician practice of UTHSC faculty members at Le Bonheur, to continue the program’s clinical and research outreach in the community.
“The Urban Child Institute is both honored and excited to support UTHSC’s pilot projects: the Integrated Care for Child Wellness program and the Family Resilience Initiative,” said Katy Spurlock, deputy director of the The Urban Child Institute. “These projects serve to move our community closer to serving the holistic health care needs of its children in the health care setting and in the home and community as well, with the child as the center of care and ensuring the child’s family is also fully included in addressing all the child’s health care needs.”
The Integrated Care for Child Wellness program focuses on children ages 8 and younger living in the targeted areas of Frayser, South Memphis, and Uptown, who are living with chronic illnesses and challenged with managing them in their community with available resources. This program will expand the work established in the 2021-2022 cycle to also include children who have experienced traumatic injury and need additional services and supports once they return to their homes and community.
“Shelby County has experienced increases in traumatic injuries, especially from gun violence, among very young children, many of whom had already experienced trauma, chronic illnesses, and other health problems exacerbated by the COVID-19 pandemic,” said Altha Stewart, MD, director of the UTHSC Center for Youth Advocacy and Well-Being.
In 2021, the ICCW offered support for Le Bonheur patients being treated for traumatic injuries and in need of follow-up services and support. Several meetings were held so the trauma team could be trained on use of the referral process with plans for a formal collaborative being established to respond to the growing number of traumatic injuries related to gun violence involving youth under 18 years old. The center’s community mental health provider network was expanded.
UTHSC is bringing on additional staff to facilitate the referral and outreach process and a subcontract with Legacy of Legends in the Frayser community ensures that community follow-up includes access to trauma-informed behavioral health, pediatric primary care, and an array of social services. Over 250 families have been engaged by the UTHSC and Legacy of Legends collaborative since the program was initially funded during the 2020-21 funding period, with referrals made to behavioral health and trauma-informed providers for follow-up in the community.
This program will have three community health support specialists working closely with the team to ensure all children experiencing chronic illness or traumatic injury are able to receive trauma-informed community-based services. And families will learn what resources are available in their community to support efforts to reduce a child’s exposure to or impact of trauma. The program is also developing relationships with new community health partners in the targeted neighborhoods and expanding those with existing community partners, such as the UTHSC Health Hub in Uptown, Christ Community Health Services, and Cherokee Health Systems in Frayser, and Advance Memphis in South Memphis.
The grant for the Family Resilience Initiative at Le Bonheur continues funding for the clinical program, which is embedded in the ULPS primary care clinic, a large, urban clinic which sees almost 15,000 unique visits per year in an approximately 95% Medicaid patient population
The Family Resilience Initiative focuses on Adverse Childhood Experiences (ACEs), social determinants of health (SDoH), and their downstream health effects, which are a public health crisis. Many chronic diseases are known to originate with, or be exacerbated by, exposure to toxic stress in childhood. Downstream health impacts may include learning and cognitive disabilities, asthma, obesity, diabetes, cancer, and behavioral health disorders such as ADHD, depression, and substance abuse. While poverty is not considered an ACE, exposure to ACEs and unmet social needs are more common in those living in lower income communities, the grant application said.
“The Family Resilience Initiative was designed to assist families in building resiliency and to provide buffers to mitigate and prevent ACEs,” said Jason Yaun, MD, associate professor in the Department of Pediatrics in the UTHSC College of Medicine. “This is a model program that can be implemented in the primary care setting and can work to set our patients up for success, as we treat and prevent the causes of many childhood and adult diseases. If we can prevent the downstream effects of childhood ACEs, it is possible to change outcomes related to physical, mental, and behavioral health. We are so grateful to the Urban Child Institute for its ongoing support of this program and our patients. Our hope is to show the benefits of a program like this, so that pediatricians can provide trauma-informed care to address ACEs and social determinants of health in the office setting.”
The Family Resilience Initative clinical program has been enrolling patients since May 2018. Through January 2022, the coordinators approached 1,209 families; 345 declined participation or were ineligible. Among the 864 patients screened, 635 (73.5%) had exposure to one or more ACEs and/or SDoH, the applicants said. Coordinators made 334 referrals for psychological counseling for the children, and have made additional referrals to adult psychological services. The coordinators have continued to follow enrolled patients and have performed 11,830 follow up activities.
The FRI research program will include a subset of the FRI clinical program and also mother/child dyads that are not enrolled in FRI clinical. The FRI research program began enrolling patients July 22, 2019. Through January 14, 2022, the research team has enrolled 249 mother/infant dyads.
“Support such as this from the Urban Child Institute helps us help the citizens of Memphis and Shelby County,” said Scott Strome, executive dean of the UTHSC College of Medicine. “We at UTHSC are grateful for the funds to support these two programs, and we are committed to working to improve the mental and physical health of children and their families in our community.”