A National Trauma-Informed Adverse Childhood Experience Screening and Intervention Evaluation Project

Area of Science:

• Pediatric Health
• Trauma-Informed Care
• Quality Improvement Science

Background:

• Adverse Childhood Experiences (ACEs) disrupt child development and increase long-term health risks.
• Pediatric providers require enhanced knowledge of ACEs, toxic stress, and trauma-informed care.
• Effective ACE screening and intervention are crucial for improving pediatric health outcomes.

Purpose of the Study:

• Evaluate pediatric provider knowledge of ACEs, toxic stress, and trauma-informed care.
• Assess the implementation of ACE screening and clinical response in pediatric practices.
• Examine patient and provider perspectives on the benefits and challenges of ACE screening.

Main Methods:

• A Quality Improvement (QI) project involving 46 pediatric practices across the U.S. from November 2021 to May 2024.
• Participants received 2-hour ACE training, monthly ECHO sessions, and QI coaching.
• A mixed-methods approach, including surveys and focus groups, evaluated program effectiveness.

Main Results:

• All 46 practices implemented ACE screening, with over half of eligible patients screened.
• Provider comfort in discussing ACEs and screening questions significantly increased.
• Patient education rates rose from 56% to 79%, with high agreement on the importance of knowing ACEs for better care.

Conclusions:

• The Trauma-Informed ACE Screening and Intervention Evaluation (TASIE) project successfully integrated ACE screening into pediatric practice.
• Providers reported increased effectiveness, efficiency, and familiarity with resources post-project.
• Both caregivers and adolescents recognized the importance of ACE awareness for improved healthcare.