RT Journal Article
SR Electronic
T1 Clinician and Staff Perspectives on Implementing Adverse Childhood Experience (ACE) Screening in Los Angeles County Pediatric Clinics
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 416
OP 423
DO 10.1370/afm.3014
VO 21
IS 5
A1 Alvarado, Gabriela
A1 McBain, Ryan
A1 Chen, Peggy
A1 Estrada-Darley, Ingrid
A1 Engel, Charles
A1 Malika, Nipher
A1 Machtinger, Edward
A1 McCaw, Brigid
A1 Thyne, Shannon
A1 Thompson, Nina
A1 Shekarchi, Amy
A1 Lightfoot, Marguerita
A1 Kuo, Anda
A1 Benedict, Darcy
A1 Gantz, Lisa
A1 Perry, Raymond
A1 Kannan, Indu
A1 Yap, Nancy
A1 Eberhart, Nicole
YR 2023
UL http://www.annfammed.org/content/21/5/416.abstract
AB PURPOSE To understand clinician and clinical staff perspectives on the implementation of routine Adverse Childhood Experience (ACE) screening in pediatric primary care.METHODS We conducted a qualitative evaluation in 5 clinics in Los Angeles County, California, using 2 rounds of focus group discussions: during an early phase of the initiative, and 7 months later. In the first round, we conducted 14 focus group discussions with 67 participants. In the second round, we conducted 12 focus group discussions with 58 participants. Participants comprised clinic staff involved in ACE screening, including frontline staff that administer the screening, medical clinicians that use screening to counsel patients and make referrals, and psychosocial support staff who may receive referrals.RESULTS Themes were grouped into 3 categories: (1) screening acceptability and perceived utility, (2) implementation and quality improvement, and (3) effects of screening on patients and clinicians. Regarding screening acceptability and perceived utility, clinicians generally considered ACE screening to be acceptable and useful. In terms of implementation and quality improvement, significant barriers included: insufficient time for screening and response, insufficient training, and lack of clarity about referral networks and resources that could be offered to patients. Lastly, regarding effects of screening, clinicians expressed that ACE screening helped elicit important patient information and build trust with patients. Further, no adverse events were reported from screening.CONCLUSIONS Clinic staff felt ACE screening was feasible, acceptable, and beneficial within pediatric care settings to improve trauma-informed care and that ACE screening could be strengthened by addressing time constraints and limited referral resources.