Familiarity and screening practices for adverse childhood experiences: Contemporary considerations from providers in a high prevalence state

Abstract

Objective: The purpose of this exploratory study was to examine adverse childhood experiences (ACEs), knowledge, and screening practices. Methods: A convenience sample of pediatric primary care providers in a health-care system within a high-prevalence state were invited to participate. The original 12-item survey addressed familiarity, tools, barriers, and prevalence regarding ACEs. Results: Study participants reported familiarity with ACEs; however, only 23% reported the use of any screening tool(s). Primary barriers included time and lack of staff and/or knowledge/training. About 77% of respondents have encountered at least eight of the 10 major types of ACEs. Most frequently encountered ACEs included parental separation or divorce, substance abuse in the household, and mental illness in the household. About 73% expressed interest in continuing medical education. Conclusions: Provider knowledge/familiarity with ACEs does not imply systematic screening. An efficient and evidence-based standardization for screening merits consideration. Continued education and training may address barriers to both provider understanding and screening of ACEs.