Implementation of the adverse childhood experiences conversation in primary care

Author:

Bodendorfer Victoria1ORCID,Koball Afton M2,Rasmussen Cary3,Klevan Judy4,Ramirez Luis3,Olson-Dorff Denyse2

Affiliation:

1. Family Medicine Residency Clinic, La Crosse, USA

2. Department of Behavioral Health, Gundersen Health System, La Crosse, USA

3. Medical Research Department, Gundersen Medical Foundation, La Crosse, USA

4. Department of Pediatrics, Gundersen Health System, La Crosse, USA

Abstract

Abstract Background Research has focused on screening for adverse childhood experiences, rather than provision of education as a part of routine anticipatory guidance. An adverse childhood experiences ‘conversation’ is one method that has not been studied empirically but represents a complimentary or alternative approach to screening which could overcome many existing barriers. Objectives This study aims to examine parent/guardian and provider acceptability/feasibility of the adverse childhood experiences conversation during well-child visits in primary care. Methods Providers engaged in a conversation with parents/guardians of patients during well-child visits in a family medicine residency clinic. Parents/guardians and providers were surveyed following the visit to examine acceptability and feasibility. Quarterly assessments to further examine provider perspectives were completed. Data were collected for 1 year. Results In total, 238 parent/guardian and 231 provider surveys were completed. Most parents/guardians felt positively (76%) about and comfortable (81%) with the information discussed and 97% felt that the conversation should be had with their primary care provider specifically. Most providers (71%) indicated that parents/guardians were receptive to the conversation, that the conversations took 1–2 minutes (60%) and that there were few disclosures of adversity (9%), none of which required mandatory reporting. Conclusions Results suggest that the adverse childhood experiences conversation is well received by parents/guardians and providers and is feasible to implement into primary care. The conversation could be used as a complimentary or alternative method to screening to further spread knowledge of toxic stress and health, provide resources for families and promote resilience.

Publisher

Oxford University Press (OUP)

Subject

Family Practice

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