By Sabrina R. Liu, Katherine E. Grimes, Timothy B. Creedon, et al., American Psychological Association PsycNet, April 2, 2021
Abstract
It is now well understood that exposure to Adverse Childhood Experiences (ACEs) is negatively linked to health and well-being across the lifespan. In an effort to disrupt ACEs exposure and its effects, there is a nationwide movement to screen for ACEs in primary care, despite a lack of well-established guidelines for assessing and responding to risk within routine care. Additionally, developing culturally responsive models of ACEs assessment is imperative, particularly because racial and ethnic minority populations face disproportionate risk of exposure to ACEs and disparities in quality of health care. Using mixed methods, we explored the feasibility, acceptability, and utility of conducting ACEs routine inquiry with an ethnically and economically diverse pediatric population through a unique collaborative practice model (CPM) consisting of an integrated, multidisciplinary team within primary care. In the CPM study, 163 children from a safety-net health system were enrolled; of those, an ACEs questionnaire was collected from 158 (97%) study participants as part of their mental health evaluation. The sample was highly ACEs exposed, with 40% of children and 56% of teens having scores of four or more. There were significant associations between level of ACEs exposure and degree of mental health impairment in both children and teens. Providers viewed the ACEs assessment process as feasible, acceptable, and to have utility for the care of the study’s diverse pediatric population. Findings highlight benefits, challenges, cultural considerations and recommendations for promoting health equity through a primary-care integrated ACEs assessment model. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Impact Statement
Racial/ethnic minority and low socioeconomic status populations face disproportionate exposure to ACEs and barriers to accessing treatment. Results of a mixed methods study found that a multidisciplinary, team-based approach to assessing ACEs in primary care is feasible, acceptable, and useful to providers working with diverse and highly stressed children and families. This model of routine ACEs inquiry can inform earlier recognition and individualized treatment to improve health and healthcare equity and outcomes for trauma-exposed youth. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
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