Adverse Childhood Experiences Screening in Primary Care

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Haro, Monica
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Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Caring sciences::Nursing , Adverse Childhood Experiences , Attention Deficit Disorder with Hyperactivity , Outcome Assessment, Health Care
Background: Adverse childhood experiences (ACES) are associated with poor mental and physical childhood outcomes. ACES are an important health topic with lack of awareness and education in the pediatric population. The American Academy of Pediatrics encourages providers to screen for ACES to mitigate toxic stress and build resilience (Isakson et al.,2020). Purpose: The purpose of this quality improvement project was to educate pediatric primary care providers on ACES, ACE screenings, and community resources for high-risk children. Increasing ACES awareness using evidence-based research and education may increase the frequency of ACE screenings in the primary care setting. Method: A quantitative design was used to measure the frequency of screening for Adverse Childhood Experiences (ACES) by pediatric primary care providers (PCPs). Participants consisted of 131 patients who attended various medical visits, including certain well child visits, behavioral visits, attention deficit hyperactivity disorder (ADHD) visits, and healthy lifestyle visits. The primary outcome measure of this study was to educate PCPs on ACES and increase the frequency of ACES screenings in their practice. Results: Following education and implementation of ACES screening, 75% of the providers expressed being more comfortable discussing ACES with patients and families and agreed to incorporate ACES screening in future practice. A Kruskal-Wallis rank sum test indicated a significant difference in ACES score between the levels of treatment, based on an alpha value of .05, χ2(4) = 63.20, p < .001. The average ACES score was 1.63, indicating most children included in this project have experienced at least one adverse childhood experience. Conclusion: Educating pediatric primary care providers on ACES and how to use the screening tool, led to 131 children being screened. With knowledge of patients’ adverse experiences, providers were able to connect patients and families to community resources to improve current health and reduce the risk of chronic diseases in adulthood. Keywords: ACES, adverse childhood experiences, pediatric primary care, pediatrics, resilience, ACE screening