Screening for Toxic Stress Response and Buffering Factors: A Case-Based, Trauma-Informed Approach to Health Equity

Date of Review: April, 2023

This resource includes two elements: 1) an asynchronous presentation focusing on ACEs screening and buffering factors; and 2) materials to support a synchronous small group discussion of a clinical case, including use of the FRAYED framework for identifying the signs and symptoms of toxic stress. This curriculum can be readily implemented in a variety of learning environments and is relatively concise. The facilitation guide is clear and useful, and has appropriate guidance for learners who may be triggered by the material. While some facilitator training is required, it is not too onerous, and may be applicable for faculty that do not have deep background or experience in ACEs or toxic stress. – Loel Solomon, Ph.D., Kaiser Permanente Bernard J Tyson School of Medicine.

Corresponding Author’s Email:


University of California, Riverside

Where was the Curriculum Implemented:

Riverside, CA

Outcomes that Have Been Reported for the Curriculum:

Self-reported learner attitude

Self-reported learner knowledge

Self-reported learner behavior in a real patient setting

Outcome and Study Design:


Level of Learner Assessment

Appreciation of content/attitude assessment (self-reflection, blogging with rubric)

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