Date of Award


Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Theresa A. Kessler


Adverse childhood experiences (ACEs) include 10 traumatic events of abuse, neglect, and household dysfunction that occur before 18 years of age. Adverse childhood experiences affect greater than 60% of the population, and approximately one in six individuals affirm that they have experienced four or more types of ACEs. They are associated with negative, long-term health outcomes in adults, including 9 out of the 10 leading causes of death in the United States (Centers for Disease Control and Prevention, n.d.; Felitti et al., 1998). The purpose of this evidence-based practice project was to implement a tailored, multicomponent intervention to mitigate the adverse health outcomes in adult survivors of ACEs. The project participants included 50 adult, primary care patients with an ACE score of one or greater at a Federally Qualified Health Center in West Michigan. A categorization tool was used to determine participants risk status (low, intermediate, or high risk). All levels of risk received ACE education and resilience interventions. Resilience interventions were individually tailored to strengthen social support and increase mindfulness practices. Intermediate and high-risk participants received an additional mental health intervention. A perceived stress scale (PSS) was administered at the time of intervention and at 12 weeks post-intervention. To determine the effectiveness of the interventions, a paired-samples t test was calculated to compare the mean intervention PSS to the mean post-intervention PSS. The mean intervention PSS was 21.09 (SD = 6.77), and the mean post-intervention PSS was 18.71 (SD = 8.22). A significant decrease from intervention PSS to post-intervention PSS was found (t (33) = 2.229, p = .033). In addition, 88.2% (n =30) of participants reported progress on one or more of the interventions. The results indicated that a tailored, multicomponent intervention reduced perceived stress and facilitated the implementation of resiliency and mental health interventions.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

R. Peterson DNP poster.pdf (493 kB)