Category 2. Implementation and Quality Improvement
| Theme | Round 1 | Round 2 |
|---|---|---|
| Theme 1. Clinicians, frontline staff, and psychosocial support staff faced logistical challenges and workflow issues with ACE screening. | ✓ | ✓ |
| Theme 2. For some frontline staff, ACE screening was viewed as a “black box” about which they knew little and were only peripherally involved. | ✓ | ✓ |
| Theme 3. Clinicians and frontline staff faced challenges in describing the purpose of ACE screening to patients and reviewing screening results with patients. | ✓ | ✓ |
| Theme 4. Clinicians were sometimes unsure how to respond to ACE screening results and wanted additional tools or support in this area; they developed opinions on areas for more training and ongoing support. | ✓ | ✓ |
| Theme 5. Clinicians and psychosocial support staff needed more resources and support for referrals. | ✓ | ✓ |
| Theme 6. There were additional challenges regarding ACE screening for certain populations. | ✓ | ✓ |
| Theme 7. Clinics had increasingly established effective ACE screening and response workflows. | ✗ | ✓ |
| Theme 8. Clinicians and frontline staff formulated suggestions to improve ACE screening implementation, quality, and acceptability. | ✗ | ✓ |
ACE = adverse childhood experience.