# MOSAICO: Modifying and Optimizing a Screener of Adverse Immigrant Childhood Occurrences for Trauma-Informed Care (TIC) in Pediatric Settings

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2024 · $171,720

## Abstract

PROJECT SUMMARY/ABSTRACT
Immigration-related trauma, including deportation, detention, and discrimination upon arrival, is detrimental to
the health and well-being of children in immigrant families (CIF). Latinx people in the United States (US)
experience high rates of such trauma. A comprehensive understanding of adverse childhood experiences
(ACEs) among Latinx CIF experiencing immigration-related trauma would facilitate recognition of and response
to signs and symptoms of trauma. While pediatricians may suspect that CIF have experienced trauma, this
trauma is not being captured in settings best equipped to identify and intervene to address childhood trauma,
such as primary care. The objective of this proposal is to build and test a primary care trauma-informed care
questionnaire (TICQ) that screens for the unique traumatic experiences (ACEs) of Latinx children in immigrant
families. This study, entitled MOSAICO: Modifying and Optimizing a Screener of Adverse Immigrant Childhood
Occurrences for Trauma-Informed Care (TIC) in Pediatric Settings, seeks to adapt, implement, and validate a
TICQ for Latinx CIF by following the Patient-Reported Outcome Measurement Information System (PROMIS)
qualitative item development and review process. Aim 1 Step 1 generates items through thematic analysis of
focus group data, participatory ideation, and a priori identification of trauma screeners. Aim 1 Step 2 classifies
(“bins”) and selects (“winnows”, pile-sorts, and ranks) items with Latinx CIF and Latinx parents. Aim 1 Step 3
revises and reviews items via cognitive interviews with Latinx CIF. Aim 2 pilot implements this new trauma
TICQ in a pediatric primary care practice in Baltimore City that primarily serves Latinx CIF. Aim 3 calibrates
screening items included in the TICQ with adapted and piloted items through confirmatory factor analysis
(CFA) of a large sample of Latinx CIF. These research aims and career development plan provide Keith
Martin, DO, MS the skills to achieve his overall career goal of becoming an independent investigator focused
on TIC of CIF in primary care. Dr. Martin’s training plan includes experiential learning and didactic coursework
to achieve the following short-term training goals: 1) Gain expertise and understanding in the theory and
clinical application of the intersection between intergenerational migration and trauma; 2) Study and optimize
screening and intervention in primary care; 3) Apply practical implementation science and clinical informatic
strategies; 4) Develop skills in screening item development and construct validation; and, 5) Continue skill
building in the responsible conduct of re-search (RCR), manuscript writing, and grant writing. Dr. Martin will
receive focused mentorship and consultation from a team of experts in primary care level intervention (Dr.
Perrin), early life adversity (Dr. Johnson), implementation science (Dr. Bass), psychometric analysis (Dr.
Musci), and health disparities among Latinx CIF (Dr. P...

## Key facts

- **NIH application ID:** 10886858
- **Project number:** 1K23HD111579-01A1
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Keith Martin
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $171,720
- **Award type:** 1
- **Project period:** 2024-07-26 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10886858

## Citation

> US National Institutes of Health, RePORTER application 10886858, MOSAICO: Modifying and Optimizing a Screener of Adverse Immigrant Childhood Occurrences for Trauma-Informed Care (TIC) in Pediatric Settings (1K23HD111579-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10886858. Licensed CC0.

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