Adverse childhood experiences among previously homeless African American women

Objective: To learn how adverse childhood experiences (ACEs) impacted the life course trajectory of formerly homeless and at-risk African American women. Design: Intersectionality and life course theory informed this qualitative pilot study, based on an instrumental case study design. Sample: Forty previously homeless and at-risk African American women, who were graduates from a long-term transitional living facility in Milwaukee, Wisconsin. Measurements: Focus group interviews and one individual interview provided data about participants’ life experiences prior to, during, and following their time at the transitional living facility, which provided supportive wrap-around services. Interviews were audiotaped, transcribed, and line-by-line thematic analysis was conducted to identify themes. Fifteen focus group participants also completed ACE questionnaires. Results: Participants reported a high prevalence of multiple ACEs, and three themes were identified: childhood experiences with family conflict, childhood experiences of abuse, and negative coping mechanisms. One-hundred percent of women had experienced at least one ACE, based on ACE questionnaire responses. Conclusions: ACEs affect various parts of patient's lives as adults. For nurses and other healthcare professionals, connecting with community resources provides the opportunity to strategically approach health improvement with wrap-around resources to improve health outcomes.