Testing a Scalable Model for Adverse Childhood Experiences-Related Care Coordination via 211 Telephone-Based Services

Adverse childhood experiences (ACEs) screening has the potential to improve health, in part by connecting families to supportive services that mitigate toxic stress. However, few studies have rigorously explored the real-world effectiveness of ACEs screening and care coordination. We tested whether connecting families with children who have one or more ACEs to telephone-based community care coordination through 211LA, a health and human services call center, achieves greater referrals and service than usual care.

Families of children ages 0 to 11 years screening positive for one or more ACEs at 1 of 3 federally qualified health centers in Southern California were surveyed at baseline, randomized into 211LA + usual care (N = 53) versus usual care alone (N = 49), and surveyed again ∼4 months later. Chi-squared tests evaluated whether group assignment was associated with differences in referrals and services.

At follow-up, more intervention than control families received at least 1 referral (86% vs 17%, P<.001), agency connection (68% vs 15%, P<.001), and service (32% vs 11%, P=.019). Families expressed high satisfaction with 211LA. There were no changes in family or child health outcomes.

Families who were connected to 211LA were more likely to receive referrals and make connections to services. Larger, longer studies are warranted. 211LA and similar providers may be uniquely positioned to provide effective ACEs screening and ACEs-related care coordination.

Clinicaltrials.gov (NCT05567250).