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Comparison of ACEs reporting between clinic and telephone-based screening
Rebecca Dudovitz1, Hayden Ngan2, Caryssa Lim Chang2,3
1Department of Pediatrics, Division of General Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America.
Plos One
|August 11, 2026
Summary
Telephone screening for Adverse Childhood Experiences (ACEs) identified more experiences than clinic screenings. Factors like parental stress and trust influenced reporting differences, suggesting tailored approaches are needed.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Screening for Adverse Childhood Experiences (ACEs) is crucial for improving health outcomes.
- The effectiveness of ACEs screening depends on its acceptability and accuracy.
- Screening modality and context significantly influence these characteristics.
Purpose of the Study:
- To compare telephone-based ACEs screenings with self-completed screenings during well-child visits.
- To identify family factors associated with differences in ACEs reporting between screening methods.
Main Methods:
- Secondary analysis of data from a pilot randomized trial involving 51 participants.
- Comparison of ACE scores from telephone screenings by 211LA and in-clinic self-completed screenings (PEARLS).
- Linear regressions were used to identify predictors of differences in ACE scores between the two methods.
Main Results:
- Telephone screenings yielded significantly higher mean ACE scores (2.08) compared to clinic screenings (1.35).
- Greater trust in healthcare providers, increased parental stress, and lower English proficiency were associated with higher ACE scores in telephone screenings.
- Specifically, reporting more ACEs via telephone was linked to higher provider trust (β=0.64), parental stress (β=0.06), and speaking English 'Well' (β=1.85).
Conclusions:
- Telephone-based screening may be an effective method for sensitive questions like ACEs.
- Family factors, including parental stress and trust in providers, influence reporting differences between screening modalities.
- The findings suggest that specific screening approaches may be preferable depending on family characteristics.