Date of Publication


Project Team

Carol Buck-Rolland, EdD, PNP and Allison Adams, MD, FAAP


Purpose: Adverse childhood experiences (ACEs) are recognized by the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) as contributing factors to poor health outcomes in childhood and beyond. Many pediatric providers are aware of the importance of ACEs, yet most do not participate in routine screening. The goal of this project was to implement ACEs screening at a semi-rural pediatric primary care office, aiming to screen 50% of eligible patients over 6 weeks. A secondary goal included increasing provider knowledge of and comfort with discussing ACEs through participation in an online training module.

Methods: Families of 3- and 5-10-year-olds presenting for routine health supervision visits completed the Center for Youth Wellness Adverse Childhood Experiences-Questionnaire. An algorithm was created to guide providers through the scoring process, which also included information on follow-up and resources. Providers volunteered to complete a CDC training on ACEs, and surveys were created to assess provider knowledge pre- and post-intervention. Rates of eligible visits and screening completion were also evaluated.

Results: Fifty-three patients were eligible and a screening rate of 47% was attained over 6 weeks. No families refused to complete screening, and no new referrals were placed for Social Work or Behavioral Health. Pre-intervention, 62.5% of providers completed the survey, while 20% completed post-intervention. CDC training did increase provider knowledge of and comfort with addressing ACEs.

Conclusion: Families are willing to complete ACEs screening. Pediatric primary care is an ideal setting for screening and utilizing provider trainings may increase provider preparedness to address ACEs.

Document Type