Date of Graduation

Spring 5-18-2023

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Elena Capella


Background: Adverse childhood experiences (ACEs) negatively affect childhood development and long-term health outcomes. Latino children face multiple adversities and social determinants of health compounded by ACEs. Community Health Workers (CHWs) have access to work with families to improve resilience and mitigate the effects of ACEs in this population.

Local Problem: In the Central Valley of California, CHWs provide support and resources to a largely Latino population with increased poverty rates, low educational attainment, lack of health insurance, and many chronic health issues, putting families at a higher risk for ACEs exposure. CHWs need further training to apply ACEs knowledge to their work in this community.

Methods: CHWs (N=14) were provided with pre- and post-questionnaires to assess knowledge obtained about ACEs. Knowledge obtained was measured by percent of score improvement, with a goal of 20% improvement for each of the five teaching modules. Responses were collected via a free Canvas teaching website, where course materials were made available to CHWs.

Interventions: As a part of a larger group project, University of San Francisco (USF) Doctor of Nursing Practice (DNP) students provided bi-weekly teaching on ACEs and other health topics to CHWs employed by a large international philanthropic organization over a two-month period. Five one-hour, synchronous, online ACEs trainings were designed and presented.

Results: The average percent improvement between pre- and post-questionnaires for each of the five modules ranged from 19% to 46%, primarily exceeding the goal of 20% improvement from baseline.

Conclusions: A nurse-led educational module on ACEs can improve knowledge for CHWs and build their self-efficacy in supporting high-risk Latino families impacted by ACEs. CHWs can gain skills to promote family resilience and deliver trauma-informed care to vulnerable families and help prevent risk for further ACEs. This community-based intervention also promotes increased CHW competencies while providing a path to future CHW state certification.

Included in

Nursing Commons