Other Titles

Moderating Effect of Positive Childhood Experiences on the Adverse Childhood Experiences-Health Relationship Among Asian American Emerging Adults

Abstract

Background: Positive childhood experiences (PCEs) are safe, stable, and nurturing relationships and environments in childhood.1 Both PCEs and adverse childhood experiences (ACEs) are common and can co-occur. Empirical studies have shown that PCEs not only buffer the negative effects of ACEs,2, 3, 4 but also positively impact physical and mental health outcomes independent of ACEs.5, 6, 7, 8 However, few studies have simultaneously examined the influence of ACEs and PCEs in Asian American populations. This study examined the association between ACEs and general health and assessed whether PCEs moderated this association among Asian American emerging adults from diverse backgrounds.

Methods: Asian American emerging adults (18-25 years), self-identifying as Asian Indian, Chinese, or Hmong Americans, were recruited online from November 2021 to November 2022. Participants completed surveys on ACEs (Philadelphia ACEs Survey), PCEs (Benevolent Childhood Experiences Scale), and general health (PROMIS Adult Global Health Scale v1.2.).

Results: In this sample (n = 814), higher cumulative ACE score was significantly associated with lower global health raw sum score (β = - 1.16, p < .001). In the multiple linear regression model, the interaction term of ACEs x PCEs was significant (β = - 0.06, p = .009), indicating that PCEs moderated the relationship between ACEs and general health. Interestingly, participants with higher PCEs (+1 SD) showed a steeper decline in global health raw sum score as ACE scores increased compared to those with lower PCEs (-1 SD) and average PCEs, suggesting that the negative impact of ACEs on health was more pronounced in individuals with higher PCE scores.

Conclusions: Consistent with previous research, Asian Americans are similar to other populations,9 as ACEs were negatively associated with general health. While PCEs moderated this relationship, higher PCEs did not mitigate the negative effects of ACEs. This finding aligns with findings from a systematic review indicating that PCEs do not always attenuate the impact of ACEs on health outcomes.10 The interaction between ACEs and PCEs may depend on factors such as timing, frequency, intensity, and duration, which should be further evaluated in future research. Advanced statistical approaches may also help clarify the complex interplay between ACEs and PCEs in shaping long-term health. Intervention programs that both prevent ACEs and foster PCEs in diverse communities are needed.

Description

This cross-sectional survey study examined the association between adverse childhood experiences (ACEs) and self-reported general health in a diverse sample of Asian American emerging adults (18-25 years) and whether positive childhood experiences (PCEs) moderated this association. Findings suggest that ACEs were negatively associated with self-reported general health. While PCEs moderated this relationship, higher PCEs did not mitigate the negative effects of ACEs.

Author Details

Wenyi Chen, PhD, MSN,CPNP-PC, RN; Chakra Budhathoki, PhD, MS, BS; Maichou Lor, PhD; Deborah Gross, DNSc, MS, BSN

Sigma Membership

Nu Beta at-Large

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Cross-Sectional

Research Approach

Qualitative Research

Keywords:

Public and Community Health, Health Equity or Social Determinants of Health, Positive Childhood Experiences, Adverse Childhood Experiences

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

Additional Files

References.pdf (88 kB)

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Adverse and Positive Childhood Experiences Affect General Health in Asian American Emerging Adults

Seattle, Washington, USA

Background: Positive childhood experiences (PCEs) are safe, stable, and nurturing relationships and environments in childhood.1 Both PCEs and adverse childhood experiences (ACEs) are common and can co-occur. Empirical studies have shown that PCEs not only buffer the negative effects of ACEs,2, 3, 4 but also positively impact physical and mental health outcomes independent of ACEs.5, 6, 7, 8 However, few studies have simultaneously examined the influence of ACEs and PCEs in Asian American populations. This study examined the association between ACEs and general health and assessed whether PCEs moderated this association among Asian American emerging adults from diverse backgrounds.

Methods: Asian American emerging adults (18-25 years), self-identifying as Asian Indian, Chinese, or Hmong Americans, were recruited online from November 2021 to November 2022. Participants completed surveys on ACEs (Philadelphia ACEs Survey), PCEs (Benevolent Childhood Experiences Scale), and general health (PROMIS Adult Global Health Scale v1.2.).

Results: In this sample (n = 814), higher cumulative ACE score was significantly associated with lower global health raw sum score (β = - 1.16, p < .001). In the multiple linear regression model, the interaction term of ACEs x PCEs was significant (β = - 0.06, p = .009), indicating that PCEs moderated the relationship between ACEs and general health. Interestingly, participants with higher PCEs (+1 SD) showed a steeper decline in global health raw sum score as ACE scores increased compared to those with lower PCEs (-1 SD) and average PCEs, suggesting that the negative impact of ACEs on health was more pronounced in individuals with higher PCE scores.

Conclusions: Consistent with previous research, Asian Americans are similar to other populations,9 as ACEs were negatively associated with general health. While PCEs moderated this relationship, higher PCEs did not mitigate the negative effects of ACEs. This finding aligns with findings from a systematic review indicating that PCEs do not always attenuate the impact of ACEs on health outcomes.10 The interaction between ACEs and PCEs may depend on factors such as timing, frequency, intensity, and duration, which should be further evaluated in future research. Advanced statistical approaches may also help clarify the complex interplay between ACEs and PCEs in shaping long-term health. Intervention programs that both prevent ACEs and foster PCEs in diverse communities are needed.