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Equity-Driven Trauma Informed Screening: Advancing Justice and Health for Every Child

The pediatric community in Santa Clara County faces the challenge of deep-rooted inequities: toxic stress from adverse childhood experiences (ACEs) is magnified among low-income, immigrant, and families of color. Here, one in three Medi-Cal eligible children suffers multiple ACEs, nearly double the California average, flagging stark disparities fuelled by social, economic, and structural barriers (Centers for Youth Wellness, 2023). These inequities directly increase preschoolers risk for asthma, obesity, cardiovascular disease, and mental health disorders, as poverty and displacement compound clinical vulnerability (Felitti et al., 1998).


Trauma-informed screening provides a transformative equity lens. When care teams shift their focus from “what’s wrong” to “what happened,” it recognizes each child’s lived experience, including the impacts of systemic racism, housing insecurity, and migration stressors. Grounded in safety, trust, empowerment, and cultural humility, this model avoids blame and builds relational trust with families who have historically experienced marginalization in healthcare (AAP, 2021).


The American Academy of Pediatrics underscores that equitable, trauma-informed pediatric care demands awareness of implicit bias, language barriers, and community context. Data show 61% of U.S. adults report at least one ACE, but for children of color and immigrant youth, prevalence and lifelong health risks are much higher (AAP, 2021; KidsData, 2025).


Screening for ACEs with equity in mind – and pairing results with accessible resources – drives measurable impact. Bilingual educators at Bay Area Community Health (BACH) implement PEARLS at every well-child visit, with motivational interviewing available in families’ preferred languages. Pediatricians partner with community organizations such as Alameda County's FoodNow for food support and Santa Clara County’s FeedKids to address structural determinants of health beyond clinical walls. Recognizing trauma is not enough; closing the referral loop to housing, behavioral health, and social services advances health justice for children and caregivers (Center for Care Innovations, 2023).


California’s ACEs Aware initiative directly addresses health disparities, reimbursing trauma screening with validated multi-lingual tools and supporting tiered interventions from universal education on co-regulation to intensive navigation for high-ACE families. Recent statewide reports show FQHC pilots yield average ACE reductions of 22% for children, with notable gains among immigrant and Latinx populations (California DHCS, 2024)...continue reading ...


Policy Advocacy

AAP California Chapter 1 urges policymakers to mandate and fund universal, culturally responsive ACEs screening and integrated behavioral health in all pediatric settings serving marginalized communities. By supporting reimbursement, workforce training, and cross-sector partnerships, we can close equity gaps and help every child thrive.


Swetang Shah, MD, MPH, CLC

Santa Clara Area Director, AAP-CA1



President's Column:

Our chapter is truly an entry point into the world of advocacy. Think of this work as a journey, one in which you can dip your toes or dive deeply into an area you are passionate about. Here are just a few ways to get involved:

Local:

Advocate within your community with a a letter of endorsement from AAP-CA1. Please reach out to your Area Director or any chapter leader to begin the process.


Regional:

Join a committee or become more engaged with our chapter by serving on our leadership team. There are so many meaningful ways to participate. Another wonderful opportunity is to share your passion and expertise by sponsoring or leading a Chapter Chat to engage pediatricians across our region. If this interests you, please contact a committee chair, Area Director, or any member of chapter leadership.


National:

There are countless opportunities to connect directly with national AAP leadership, and many of you already do. If you join national sections or initiatives, please remember to keep our chapter informed, and continue to participate locally as well!


Global:

Many in our chapter are involved in caring for children across the world. If you participate in global health work, please share your experiences and the extraordinary impact you make. These stories remind us of the profound power we have to care for children everywhere.


Last month, I had the opportunity to participate in a maternal-child health mission trip to Guatemala, joining the dynamic work at Hospital de la Familia in Nuevo Progreso. Organizations like this are always looking for clinicians to join their missions. The trip was an incredible chance to reset, recenter, and be reminded that children, regardless of where they live or what is happening in the world, benefit deeply from the care we are able to provide. With humility and strength, we move forward together.



Please encourage your colleagues to join our chapter! Here is the link to join, and feel free to share: AAP California Chapter 1 Membership.


Neel Patel, MD, FAAP

President, AAP-CA1

It Starts with a Conversation: How Motivational Interviewing Can Transform Childhood Obesity Prevention

My family feels ready to make a small change - we will stop drinking soda for one week.”



Childhood obesity remains one of the most pressing challenges of our time. As pediatricians, we witness its impact every day on children struggling with low self-esteem, showing early signs of insulin resistance, and families feeling unsure where to start. Recently, the American Academy of Pediatrics (AAP) released its Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity, providing a comprehensive framework to support pediatricians in managing this complex condition.

One of the key approaches highlighted in the guideline is Motivational Interviewing (MI), a powerful tool that goes beyond prescriptions or diet plans, instead it starts with a conversation. MI focuses on partnership rather than persuasion. Instead of telling families what to do, we guide them to discover their own reasons and readiness for change. In our daily practice 4 steps of MI might look like below image...continue reading...


Childhood obesity prevention isn’t just about food or exercise - it’s about hope, support, and connection. And sometimes, it all begins with a simple question:


“What’s one small change your family feels ready to make today?”


Vaishali Benaka Hebbar, MD, FAAP, CLC

Vice Chair, Obesity Prevention Committee, AAP-CA1

How To Turn On The Switch With The Rider and The Elephant

As a pediatric dentist with 17 years of experience, I understand the challenge of motivating positive change in parents and children, especially when it comes to health habits such as cavity prevention. My approach is inspired by Chip and Dan Heath's Switch: How to Change Things When Change Is Hard, which emphasizes the need to engage both rational thought (the Rider) and emotions (the Elephant) to instigate change.


The key is to provide specific instructions for the Rider and emotional motivation for the Elephant. For example, "exercise" is too vague, but "do cardio 30 minutes 3 times a week" is actionable. However, without emotional readiness, even clear instructions can be ignored. Hope, the "I can do that" feeling, is a powerful motivator. If advice is too difficult, parents won't implement it...continue reading...


My "secret" about ice cream is that evidence suggests it can be healthy, as discussed in David Merritt Johns's "Nutrition Science’s Most Preposterous Result" in The Atlantic (2023). This article references studies correlating ice cream with lower heart disease and type II diabetes risk. While I don't tell patients ice cream is "good for you," I suggest a small scoop after dinner instead of other candy if they must have sugar...continue reading...


In summary, for cavity prevention:

  • No: Juice, crackers, chocolate milk, soda
  • Yes: Bread, meat, ice cream, chocolate, and peanut butter.


To combat obesity, consider what you, as the doctor, can affirm for the patient. This approach makes the necessary "no's" more palatable and increases the likelihood of instigating positive change.


Dr. Roger Lucas, DDS

Author of More Chocolate, No Cavaties

Psychological Effects of School Crisis Drills

At our last meeting, the School Health Committee discussed a new report on the psychological effects upon children and youth of school active shooter drills. According to the K-12 School Shooting Database, there were 254 incidents in the 2024-2025 academic year. To prepare for such attacks, lockdown drills are practiced in 98% of K-12 schools nationwide. At least 37 states require active shooter drills, some as often as 5 times a year. The AAP has made significant efforts in this area, including an AAP policy statement in 2020 about student involvement in crisis drills. However, a new federal report stresses the psychological effects upon students and makes strong recommendations to reduce the potential harm these drills can cause, especially in students previously exposed to gun violence and to students with disabilities. 


The report strongly recommends against high-intensity simulations that rely on sound effects (such as gunshot sounds), fake blood, or simulated violence. The report also recommends against deceiving students and staff by leading them to think that the drill is real. Not everyone will experience active shooter drills in the same way...continue reading...


Renee Wachtel, MD, FAAP

Chair, Committee on Developmental & Behavioral Pediatrics and School Health Committee, Area Director, Alameda County, AAP-CA1

Chapter Events

Amplify Your Advocacy Op-Ed Writing for Pediatricians

Wednesday, December 10|6:30-8:00pm|Virtual


AAP-CA1 invites you to join the joint committee meeting with the Committee on Developmental & Behavioral Pediatrics and the School Health Committee, held virtually on Tuesday, October 28, from 7:00 p.m. to 8:30 p.m. Don’t miss this important discussion on developmental, behavioral, and school health topics!


Cannabis Conversations: Protecting Youth Health Through Clinical Practice and Public Policy Partnerships

Tuesday, December 16|6:30-8:00pm|Virtual



Join us Tuesday, December 16 from 6:30–8 PM (PT) for an overview of youth cannabis trends and practical prevention, screening, and policy strategies to help protect children and adolescents!

Childhood Nutrition & Obesity Prevention Committee

Wednesday, Janunary 21|6:00-7:00pm|Virtual



Join us on January 21 at 6 PM for the Childhood Nutrition & Obesity Prevention Committee meeting. Internal Medicine Physicians Dr. Smruti Nalawadi and Dr. Shagun Bindlish will guide an interactive conversation on nutrition trends, obesity prevention, and how clinicians can work together to promote healthier outcomes for children and families.

Chapter Leadership Positions

Apply for Area Director Positions!



As an Area Director, you'll be part of a dynamic team representing one of our 11 diverse geographic areas. You will become a voting member of our chapter board and engage with local pediatric providers to advocate for children's health through the American Academy of Pediatrics (AAP). Volunteer alongside a supportive leadership team dedicated to shaping the future of pediatric care.


Time commitment: 2-4 hours per month



Volunteer Area Director Positions:

  • Monterey Area Director
  • North Coastal Area Director


Perks and Benefits:

  • Membership on AAP Board: Gain valuable experiences and networking opportunities
  • Discounted CME Events: Access quality education at reduced rates.
  • Advocacy Day in Sacramento: Participate in impactful advocacy efforts.

Apply for CATCH Co-Facilitator Positions!


The role of a Chapter CATCH Facilitator (CCF) is to encourage and support pediatricians in their chapter as they work to collaborate within their communities to advance the health of all children. Chapter CATCH Facilitators represent the national AAP CATCH Program and must be a national AAP member as well as a chapter member. 

CATCH’s mission is to support pediatricians to collaborate within their communities to advance the health of all children. Our vision is that every child in every community reach optimal health and well-being.

If you’re interested, please email info@aapca1.org


The term length is 3 years and is renewable. Applications open until filled.

AAP-CA1 Advocating for Children Together (ACT) Conference in 2026


The AAP-CA1 Advocacy Committee is excited to announce that we will be hosting the Advocating for Children Together (ACT) Conference in 2026! Building on the success of the previous ACT Conferences in 2019 and 2020, this event will bring together pediatricians who are passionate about improving child health and provide an opportunity for skill-building and networking. The ACT Conference will feature TED-style talks from dynamic leaders, hands-on workshops with experts in politics, public health, and mass media, and opportunities to meet and collaborate with pediatrician advocates in our community. 


As planning begins, we are recruiting enthusiastic volunteers for the Speaker Committee, a conference planning committee that will shape the engaging talks and activities of the conference. Those who are interested can sign up using this form. Participating in the committee is a meaningful way to support pediatric advocacy, connect with colleagues, and help build a conference that equips pediatricians with the skills, opportunities, and connections needed to make a difference in children’s health. 

If you have any questions about the conference or the planning committee, please reach out to Lena Rothstein at lcrothstein@gmail.com. Access the 2019 ACT Conference or sign up to join the planning committee here!

California Pediatrics Podcast: Dr Nicole Webb “Using Our Voice to Advance Child Health” - Episode 6


California Pediatrics is a podcast by pediatricians from the four California AAP chapters, covering current issues, career highlights, and parent tips. Episode 6 features hosts Melissa Ruiz, MD, FAAP and Eric Ball, MD, FAAP in conversation with special guest Nicole Webb, MD, FAAP, who shares her career journey and deep passion for child advocacy.


Pediatric Careers in California!


Explore our job board for exciting career opportunities or share one of your own. Visit aapca1.org/jobs/.


  • Chapter Members: Enjoy a discounted rate of $50 for a 90-day job posting and promotion.
  • Non-Members/Corporate Entities: Post for 30 days at $100.


Take the next step in your pediatric career today!

Pediatric Jobs Available!

UCSF School of Medicine and UCSF Benioff Children’s Hospitals Division of General Pediatrics, Department of Pediatrics - San Francisco, CA

Pediatrician – Tamalpais Pediatrics - Marin County, CA

Northern California Pediatric Hospitalist Opportunity – Gould Medical Group - Modesto, CA

Developmental Behavioral Pediatrician - Sutter Health - Santa Rosa, CA

BC/BE Pediatric Generalist physician - Inspire Health Medical Group - Fresno, CA

Resources

California Pediatrics Podcast



Ep. 6: Dr. Webb - Using Our Voice to Advance Child Health


Other Episodes

Dr. Benjamin Hoffman: Advocacy in Product Safety


Dr. Ilan Shapiro: Pediatricians on Social Media


Recommended by AAP x California Pediatrics Podcast

4 Ways to Keep Kids Healthy During the Winter Holidays


Don’t let respiratory viral illnesses like the flu, RSV and COVID-19 spoil your family’s holiday fun. Read more about food and drink preparation, selecting safe gifts, and decoration safety practices!


Recommended by AAP-CA1

Samples of Recalled Baby Formula Test Positive for Bacteria That Causes Botulism


The outbreak of infant botulism linked to ByHeart formula has affected 31 infants in 15 states. Read more about symptoms of infant botulism.


Recommended by AAP News

Cal-MAP: Mental Health Support Resources


Cal-MAP’s team of mental health specialists supports primary care providers (PCPs) treating youth with mental health needs through education, consultation, and resource navigation.


Register for the Cal-MAP consultation program here: https://cal-map.org

 

Contact Us:

Phone:

800-253-2103

Email: info@cal-map.org

Making Career Transitions

Over the course of your career as a pediatrician, you may decide to completely change course or make small tweaks to your current position. This time in your life can be both confusing and exciting as a new chapter unfolds. Below are resources for you to explore.

Dairy Council of California

Books:


Dairy Council of California elevates the health of children and communities by

promoting lifelong healthy eating through improved access to nutrition education and nutritious foods.

Access cultural relevant resources for feeding infants and toddlers developed through partnership with NACCHO and grant funding from the CDC.


Explore a Healthy Eating for Families nutrition education booklet.


For questions, contact: boconnor@dairycouncilofca.org

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Facebook: California Chapter 1, American Academy of Pediatrics

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Website: https://aapca1.org/

Your membership makes a difference for children in California, thank you!


The AAPCA1's ability to advocate on behalf of children is only as strong as the support we receive from our members. Encourage your colleagues to join today by visiting the AAPCA1 website.


Our mission is to promote the optimal health and development of children and
adolescents of Northern California in partnership with their families and communities, and to support the pediatricians who care for them.

Executive Committee:

President: Neel Patel • Vice President: Saul Diaz Martinez

Secretary: Kerrilyn Rice • Treasurer: Amita Saxena • Past President: Nicole Webb



Area Directors:

North Valley: Aishwarya Taneja • Sacramento Valley: Lena van der List • Central Valley: Deborah Shassetz • South Valley: Sireesha Palkamsetti • San Francisco: Ryan Alanzalon • Santa Clara: Swetang Shahm • San Mateo: Jonathon Everett • North Coastal: VACANT • Monterey Bay: VACANT • Alameda County: Renee Wachtel • Contra Costa/Solano: Jennifer Anne Miller


Pediatric Insider News Editors:

Christy Capestany • Nicole Anderson



Staff:

Executive Director: Yolanda Ruiz Project Coordinator: Sana Sayyid •

Marketing Assistant: Arathzy Portillo