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Screening for Adverse Childhood Experiences (ACEs) in primary care is crucial. A collaborative practice model demonstrated feasibility and utility for assessing ACEs in diverse pediatric populations, linking exposure to mental health outcomes.

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Area of Science:

  • Pediatric Health
  • Mental Health Services
  • Health Equity

Background:

  • Adverse Childhood Experiences (ACEs) negatively impact lifelong health.
  • Racial and ethnic minorities face higher ACEs risk and healthcare disparities.
  • Primary care screening for ACEs lacks established guidelines, especially culturally responsive ones.

Purpose of the Study:

  • To explore the feasibility, acceptability, and utility of routine ACEs inquiry in a diverse pediatric population.
  • To assess ACEs screening within a unique collaborative practice model (CPM) in primary care.
  • To inform culturally responsive models for ACEs assessment and intervention.

Main Methods:

  • Mixed-methods approach.
  • Utilized a collaborative practice model (CPM) with an integrated, multidisciplinary team.
  • Collected ACEs questionnaires from 158 children in a safety-net health system during mental health evaluations.

Main Results:

  • High ACEs exposure rates: 40% of children and 56% of teens had scores of four or more.
  • Significant associations found between ACEs exposure levels and mental health impairment in children and teens.
  • Providers deemed the ACEs assessment process feasible, acceptable, and useful for diverse pediatric patients.

Conclusions:

  • Primary care integrated ACEs assessment models can promote health equity.
  • Findings highlight benefits, challenges, and cultural considerations for implementing ACEs screening.
  • Recommendations are provided for improving ACEs assessment and response in routine pediatric care.