Exploring Patient Preferences for Adverse Childhood Experiences Education in the Primary Care Setting: A Focus Group...

Although the long-term effects of adverse childhood experiences (ACEs) are well studied, there is a lack of literature about how patients understand and prefer to discuss these issues in health care settings. This qualitative study explored patients' knowledge of ACEs, their preferences for learning about the health effects of trauma, and their perspectives on integrating ACEs education, including patient education posters, into primary care visits.

Two focus groups were conducted with 8 patients at an internal medicine clinic in the midwestern United States. Discussions were transcribed verbatim and analyzed using inductive thematic content analysis to identify key themes related to health literacy, patient preferences for ACEs screening and discussions in clinical care, and reactions to ACEs educational posters.

Three main themes emerged: 1) understanding of ACEs, including varying levels of health literacy and familiarity with the concept; 2) preferences for learning about ACEs, with participants emphasizing the importance of optional screening and trauma-informed communication; and 3) responses to posters, where infographic-style posters were viewed as effective conversation starters but required careful attention to language, imagery, and inclusivity.

Patients were willing to engage in discussions about ACEs during primary care visits when approached with compassion and expertise. Findings highlight the need to tailor communication strategies to individual readiness and literacy levels. Incorporating patient feedback into ACEs education and screening processes may enhance trust, improve patient-clinician relationships, and support holistic care.