Whole Child Well-Child Visits: Implementing ACEs and SDOH Screenings in Primary Care

Area of Science:

• Pediatrics
• Public Health
• Family Medicine

Background:

• Adverse childhood experiences (ACEs) and social determinants of health (SDOH) are linked to negative health outcomes.
• Primary care settings offer opportunities for early identification and intervention for families with young children.
• Building family resilience is crucial for mitigating the long-term effects of ACEs and SDOH.

Purpose of the Study:

• To develop and implement a program screening for ACEs and SDOH in children aged 9 months to 5 years within a primary care setting.
• To provide timely interventions and support to families identified with ACEs and/or SDOH needs.
• To establish a model for integrated care that empowers families and builds resilience.

Main Methods:

• Screening for ACEs and SDOH during well-child visits for children aged 9 months to 5 years.
• Development of programmatic criteria and referral resources for identified needs.
• Implementation of a database to track enrolled families and reported outcomes.
• Enrollment of 246 families in the first year of the program.

Main Results:

• 56.9% of caregivers reported one or more ACEs for their child.
• 63% of caregivers reported an SDOH need.
• 39.4% of caregivers reported both ACEs and SDOH needs.
• The average number of ACEs reported per child was 0.94.

Conclusions:

• The program successfully identified a high prevalence of ACEs and SDOH among families with young children in a primary care setting.
• The findings underscore the importance of integrated screening and intervention models to support family well-being and resilience.
• This primary care-based model, with wraparound resources, offers a scalable approach to mitigate and prevent ACEs and address SDOH.