Screening for Adverse Childhood Experiences in Primary Care: Recommendations for Practice
View/ Open
Abstract
Adverse Childhood Experiences (ACE) increase the risk of childhood injury as well as long-term negative mental and physical health outcomes. ACE are defined as potentially traumatic events occurring during childhood and adolescence that can have negative, lasting effects on health and well-being (Centers for Disease Control and Prevention, 2010). Childhood trauma can lead to the development of chronic diseases, mental illness, violence and being a victim of violence, as well as financial and social problems later in life. Despite the clear links between childhood trauma and chronic diseases in adulthood, there continues to be a lack of ACE screening in primary care settings. Primary care providers are well positioned to minimize the gap between evidence-based research and clinical practice leading to chronic disease management that is founded on quality patient care (Sarvet, 2017). ACE screening, alone, can be an intervention that reduces the frequency of overall health care facility use by patients leading to an overall reduction in healthcare costs (American Academy of Pediatrics, 2014; Felitti et al., 1998; Glowa, Olson, & Johnson, 2016). Incorporating ACE screening as standard of practice in primary care can lead to earlier identification and treatment of high-risk patients. The purpose of this project was to assess the feasibility of ACE screening in a primary care clinic in the Fargo area serving a population at high-risk for experiencing childhood trauma. Primary care providers are well equipped to close the gap between ACE research and clinical practice, however ACE screening is not widely conducted (Glowa et al., 2016). Identifying barriers to ACE screening in primary care and developing strategies to overcome them can improve the intention of healthcare providers to screen for ACE in their practice ultimately eliminating the gap between evidence-based ACE research and clinical practice.