Looking beyond the trauma and moving forward with the positive
Lourdes Valdez, a general pediatrician at the Mayo Clinic in Rochester, Minnesota, is doing more than just implementing the HOPE framework – she’s studying it. She first learned about the HOPE framework and the benefits of positive childhood experiences (PCEs) in 2022 while working in Butte County at First 5 California. Witnessing children and their caregivers experience trauma from wildfires, she knew that it was important to have a strength-based, healing-focused framework that could support their resiliency. The organization received a grant to train staff as a HOPE Facilitator, and Valdez was trained.
Valdez was excited to bring the HOPE framework to her practice, in the patient visits and in every interaction. She wanted to move beyond just looking at the trauma, and toward moving forward to the positive.
“I need to know what has happened to our patients that can help me understand their context better. But it was something that I could not make too much of a change for the good. I learned about it, but okay, now what? And well, with the positive childhood experience, I love that it’s something we can control.”
Implementing and evaluating how positive experiences are promoted by clinicians and received by families
Valdez and her colleagues teamed up to create a study that focused on patient perceptions of the HOPE framework in their interactions with their clinicians.
“I think that positive childhood experiences are vaccines against adversity, so I think they’re important to bring it up at every encounter.”
Valdez said that she and her colleagues had a sense that they were disseminating information about PCEs, but didn’t know how much it was coming through. They created an 8-question survey to find out. One question was, “During your visit today, were you reminded of/learned of resources in the community or safe nurturing places to take your child?” Another question was about whether the patient received pamphlets about positive childhood experiences. 53% of the patients surveyed reported that pediatricians promoted PCEs during a visit.
Utilizing the HOPE framework for community-specific recommendations
Before the next round of the survey, Valdez did more training with her colleagues. They worked harder to give examples of things that families can do in their communities to create nurturing environments for their children. They made sure their recommendations were specific and local. She and her colleagues created flyers that discussed the Four Building Blocks of HOPE, the key types of PCEs (relationships, environments, engagement, emotional growth) central in the HOPE framework. For the Building Block of engagement, Valdez would talk to caregivers about how to engage their young ones by creating family traditions.
“Traditions are important to build this sense of belonging that is so important for kids,” said Valdez. It could be reading a book together at night or having ice cream together every time you go to the doctor — the idea is to create connection and to create routine.
They created educational flyers and put posters in the waiting rooms. By the end of the study, roughly 86% of patients reported that pediatricians promoted PCEs during a visit. Her team saw that as a success.
In the time since the study, Valdez has been working at the Mayo Clinic, and hopes to incorporate her takeaways in the work there. She and her new colleague are spreading the word about PCEs–not just the theory, but the neuroscience behind it.
