Date of Publication


Project Team

Faculty Advisor: Brenda Hamel-Bissell, Ed. D, RN. Agency Advisor: Madeline Mann, MSN, FNP. Agency: Timber Lane Pediatrics, Milton, VT


Mitigating Negative Impacts of Adverse Childhood Experiences:

A Strength-Based Approach

Nicholas Montello, RN

Purpose: Adverse Childhood Experiences (ACEs) are common among Vermont youth, and Vermont has insufficient treatment resources to address their negative impacts. A strength-based approach (SBA) mitigates the negative impacts of ACEs by using a person’s assets to build resilience to ACEs. This project is designed to increase healthcare worker and patient/caregiver knowledge of ACEs via the SBA.

Methods: An evidence-based quality improvement intervention was implemented at a pediatric primary care office in rural Vermont, based on the Bodega Model for a strength-based approach. Healthcare worker knowledge and use of the SBA was assessed after an educational intervention. Materials with information on the SBA were set up for patients in the waiting room. Surveys assessed patient knowledge and perceptions of the SBA.


  • 62% of healthcare workers reported increased knowledge of SBA elements after the educational intervention, and workers reported a 50% increase in usage of SBA elements in the 3 months after the educational intervention.
  • 60% of healthcare workers saw the SBA as cost effective.
  • 100% of surveyed patients reported confidence in using the SBA.
  • All patients who responded to surveys believed that the SBA could help them deal with adversity.

Conclusions: The SBA can be effective in primary care for mitigating the negative impacts of ACEs, as noted by health care workers, patients and caregivers.

Healthcare workers increased their usage of this evidence-based intervention after the educational session, suggesting that lack of knowledge of the SBA could be a prior barrier to use.

Document Type


Included in

Pediatrics Commons