Discussion boardresponse Theassignment is a discussion board response to a student™s post**Minimum of two scholarly

Module VI

• Identifying Information (Journal, Year, Title, Authors):
• PLOS One; 2020
• Disease burden of adverse childhood experiences across 14 states
• Geetha M. Waehrer, Ted R. Miller, Sara C. Silverio Marques, Debora L. Oh & Nadine Burke Harris
• Authors qualifications to write the article (credentials, professional affiliations):
• Geetha M. Waehrer, PhD & Ted R. Miller, PhD are both economists and research scientists at Pacific Institute for Research and Evaluation (PIRE). Both have been published in several peer-reviewed journals and Miller is a leading expert on injury and violence incidence, costs and consequences, as well as substance abuse costs. His cost estimates have been used by the Centers for Disease Control among other federal agencies and his current research focus is on health-related costs and safety measures. Among other awards he has been recognized with an Excellence in Science Award and a Distinguished Career Award from the American Public Health Association.
• The problem addressed in the study: Adverse childhood experiences (ACEs) are associated with poor health across the lifespan. There is a knowledge gap in relation to health effects independent of associated increased risk factors (smoking, obesity, and heavy drinking).
• The purpose of the study: To assess the incidence of the previously mentioned three risk factors association with ACE exposures, to determine if health risks associated with ACEs are still increased independent of these modifiable risk factors, and to evaluate if these risk factors are consistent in different US states.
• The research question (s) (and/or hypothesis) used in the study: To evaluate if stress-related hormonal changes are independent contributors to health risks, or if behavioral risk factors may be root cause.
• Review of current and relevant literature (date range, types of studies): 65 sources were cited in this article, most within the 5-year range though several much older articles also cited. Most articles were Quantitative in nature, evaluating the association between ACEs and specific disease processes or modifiable risk factors.
• Sampling procedures-110,076 samples from Behavioral Risk Factor Surveillance System across 13 states divided into groups of 1, 2-3, and 4+ ACE exposures. Analysis was restricted to individuals with complete socioeconomic and ACE history.
• Design and methods used in the study- Wald Test, Logit Model
• Ethical issues/IRB (informed consent)- No declared ethical concerns. Study used third-party data from the CDC that is public information.
• Methods for data collection and analysis. What tests were run to analyze data? What software was used in the data analysis process?:
• Wald Test- used to determine statistically significant differences in ACE exposure categories
• KHB program in Stata 15 was used to calculate errors
• Logit Model- weighted controls for ACE exposure categories.
• Findings- ACE exposure was found to independently contribute to poor health-related outcomes, but risk did not increase with most disease processes with increased ACE exposure (outside of asthma, arthritis, COPD, cardiovascular disease, and depression). Diabetes and cancer were found to have only a modest increase outside of modifiable risk factors, and risk did not increase with increased ACE exposure. State-specific changes were also noted, but reasons for these changes were not explored.
• Generalizability of findings: Findings may be useful for determining chronic disease risks for care providers outside of recognized genetic and lifestyle risk factors.
• Study limitations: Researchers noted that state-specific reasons for ACE related health concerns were noted, but causes were not explored and would require longitudinal studies.
• Contributions to nursing research and practice- Increased knowledge about the effects of trauma and adverse childhood experiences on chronic health concerns. Useful for determining risk and guiding patient education about their increased risks and potentially modifiable risk factors.

References

Pacific Institute for Research and Evaluation (PIRE). (2021). Geetha Waehrer, PhD: Research

Scientist. https://ncr.pire.org/person/geetha-waeher/

Pacific Institute for Research and Evaluation (PIRE). (2021). Ted Miller, PhD: Senior Research

Scientist II. https://ncr.pire.org/person/ted-miller/

Waehrer, G.M., Miller, T.R., Marques, S.C.S., Oh, D.L. & Harris, N.B. (2020). Disease burden of

adverse childhood experiences across 14 states. PLOS One, 15(1). e0226134.

https://doi.org/ 10.1371/journal.pone.0226134