Journal of primary care & community health · 2026
Burnout and Adverse Childhood Experiences in the Maternal and Child Health Workforce.
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Cox Katherine, Clausen Michelle, Vyas Amita
Аннотация
BACKGROUND: Burnout has risen sharply since the COVID-19 pandemic, especially in healthcare. Emerging evidence suggests adverse childhood experiences (ACEs) may increase burnout risk. This study examined the relationship between burnout and ACEs within the maternal and child health (MCH) workforce and assessed ACE prevalence.
METHODS: An anonymous cross-sectional survey of MCH clinicians (n = 477) was administered via Qualtrics. Eligibility included being ≥18 years old, working in the MCH workforce, and practicing ≥1 year. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). ACEs were measured using the ACE questionnaire with minor wording modification. ANOVA and linear regression were used to evaluate associations between ACE exposure and burnout.
RESULTS: Over half (57%) reported ≥1 ACE; 31% reported ≥4. Burnout levels were high (Personal Accomplishment = 26.47 ± 8.94; Emotional Exhaustion = 32.98 ± 8.56; and Depersonalization = 15.62 ± 5.82). Participants with ≥4 ACEs had significantly higher emotional exhaustion and lower personal accomplishment. Those with 1 to 2 ACEs had lower emotional exhaustion and depersonalization than those with zero ACEs.
CONCLUSION: The MCH workforce shows a high prevalence of ACEs and elevated burnout. A dose-response relationship was observed, with ≥4 ACEs associated with greater burnout. However, lower burnout among those with 1 to 2 ACEs suggests possible resilience pathways. Workforce programs should account for early life adversity and integrate resilience-informed approaches.
METHODS: An anonymous cross-sectional survey of MCH clinicians (n = 477) was administered via Qualtrics. Eligibility included being ≥18 years old, working in the MCH workforce, and practicing ≥1 year. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). ACEs were measured using the ACE questionnaire with minor wording modification. ANOVA and linear regression were used to evaluate associations between ACE exposure and burnout.
RESULTS: Over half (57%) reported ≥1 ACE; 31% reported ≥4. Burnout levels were high (Personal Accomplishment = 26.47 ± 8.94; Emotional Exhaustion = 32.98 ± 8.56; and Depersonalization = 15.62 ± 5.82). Participants with ≥4 ACEs had significantly higher emotional exhaustion and lower personal accomplishment. Those with 1 to 2 ACEs had lower emotional exhaustion and depersonalization than those with zero ACEs.
CONCLUSION: The MCH workforce shows a high prevalence of ACEs and elevated burnout. A dose-response relationship was observed, with ≥4 ACEs associated with greater burnout. However, lower burnout among those with 1 to 2 ACEs suggests possible resilience pathways. Workforce programs should account for early life adversity and integrate resilience-informed approaches.