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The WHO 18 question ACE questionaire

The World Health Organization (WHO) adopted the ACE screening tool, and used [an apparently modified version of it, in its 2013 Survey of the World's Healthiest Children. But when I briefly looked at it, on the WHO website, I thought it contained a total of eighteen [rather than ten questions in the original ACE screening tool] primary questions. I also didn't know how they scored their WHO 18 primary question ACE survey, or interpreted what someone's score was, and what it means. Is anyone familiar with this?

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Originally Posted by Robert Olcott: 

The World Health Organization (WHO) adopted the ACE screening tool, and used [an apparently modified version of it, in its 2013 Survey of the World's Healthiest Children. But when I briefly looked at it, on the WHO website, I thought it contained a total of eighteen [rather than ten questions in the original ACE screening tool] primary questions. I also didn't know how they scored their WHO 18 primary question ACE survey, or interpreted what someone's score was, and what it means. Is anyone familiar with this?

Hi Robert, I cannot claim personal knowledge on your questions, however, in doing a little digging I found the following information that addresses both of your questions at this WHO link  http://www.who.int/violence_in...r_analysing.pdf?ua=1 

 

In case there is any problem with the link, the reference reads:

 

Adverse Childhood Experiences International Questionnaire (ACE-IQ) Guidance for Analysing ACE-IQ Context The ACE-IQ is designed to be integrated within broader health surveys to allow analysis of associations between adverse childhood experiences and subsequent health outcomes and health risk behaviours. This means that there are some key aspects of its design which need to be understood so that it is applied properly, and so that the data generated is useful. Coding Question codes As a standalone questionnaire the question numbers run from Q0 - Q8. However, as these questions will most often be integrated into other surveys we have coded them into six groups (C, M, P, F, A, V) to allow cross-referencing for researchers. Hence, whatever numbers are given to the questions when included within your own survey, please keep the letter codes present as well so that it's possible to easily refer between questionnaires. Question codes: Core questions: C Marriage questions: M Parents/guardian questions: P Family questions: F Abuse questions: A Violence questions: V Response codes A numerical code has been ascribed to each possible response for a question. This number has been placed within square brackets [ ] and is there to allow the data to be entered and more easily processed within a spreadsheet for data analysis. Note: in all cases, [66] is the code for "not applicable"; [77] is the code for "don't know/not sure" and [88] is the code for "refused". Analysis As the development of the ACE-IQ is at the pilot stage, we would like to adopt two methods of analysis to allow us to ascertain the most appropriate approach to determine an accurate overall ACE score for a participant. The first we'll call the binary version, the second the frequency version. In both cases the questions from the ACE-IQ about childhood experience have been sorted into 13 categories: emotional abuse; physical abuse; sexual abuse; violence against household members; living with household members who were substance abusers; living with household members who were mentally ill or suicidal; living with household members who were imprisoned; one or no parents, parental separation or divorce; emotional neglect; physical neglect; bullying; community violence; collective violence. To calculate the ACE score using the binary version, check the participant's answers against Table 1 in "Calculating the ACE score from the ACE-IQ" (see below). If the participant answered in the affirmative (whether with once, a few times, or many times) then that counts as a yes, and so that response should be circled, and a 1 placed in the final column. Once completed you will get an answer from 0 to 13. This is the ACE (binary) score for that individual. To calculate the ACE score using the frequency version check the participant's answers against Table 2 in "Calculating the ACE score from the ACE-IQ" (see below). This time, only circle yes if the participant's answers exactly match the written question in the table (you'll note that for some questions only certain frequencies are included). As before, once completed you will get an answer from 0 to 13. This is the ACE (frequency) score for that individual. Once you've calculated the two ACE scores, you can then look at the relationship between the ACE scores and the health outcome or health risk behaviour you're interested in by plotting a dose-response curve, or rather exposure (ACE score) - behaviour/health outcome curve. One important area to examine at this pilot stage is whether a relationship is seen between (binary) ACE score and health outcome/behavior or whether a relationship is only seen between ACE score and health outcome/behavior when the frequency ACE score is used (it is this latter phenomenon which is seen in the original ACE studies). If you look at the Centre for Disease Control (CDC) website for the ACE study, you can see the different ways that the data generated can be analysed. Not only can you generate the dose-response curves discussed above, but you can also generate data on demographics and prevalence within certain populations from the ACE-IQ responses. See http://www.cdc.gov/ace/data.htm Further details of health outcomes and behaviours which have been analysed to determine their relationship with exposure to ACEs can be found here: http://www.cdc.gov/ace/outcomes.htm 

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