Increasing Provider Knowledge of Adverse Childhood Experiences Screening in Pediatric Primary Care

Abstract

Purpose The purpose of this quality improvement project was to develop and present an evidence-based educational presentation for primary care pediatric providers about Adverse Childhood Experiences (ACEs) and current evidence-based ACEs screening tools at West Valley Pediatrics. Background The 2018 report from the National Survey of Children’s Health (NSCH) found that roughly 30% of respondents reported at least one ACE, with 14% of respondents experiencing more than two. Exposure to ACEs can lead to children experiencing toxic stress, putting them at increased risk for health and behavioral issues including smoking, drinking alcohol, and antisocial behaviors. Screening for ACEs can help identify children and their families at increased risk for ACEs and can be helpful in early referral for support services or intervention. Methods This quality improvement (QI) project used a quantitative, one group study design with a convenience sample of primary care providers from West Valley Pediatrics. Data for this project was collected using a pretest, evidence-based educational presentation, posttest, and a follow-up survey. Results A total of five (n=5) pediatric primary care providers at West Valley Pediatrics completed all components of the project. Results of the pretests and posttests revealed an average score of 73% on the pre-test and 81% on the posttest. Although the paired test showed a p value of 0.17, which is not considered statistically significant (p value <0.05), the participant scores increased by 9% from the pretest to the posttest after the intervention. The follow-up survey found that participants stated an intent to start screening and felt the intervention increased their knowledge. Conclusions Pediatric primary care providers have a critical role in early identification and intervention with children experiencing ACEs can improve the long-term outcomes of children with ACEs. Provider education is the first step to addressing ACEs in pediatric primary care. This project demonstrated that with education, participants had an increased knowledge of ACEs and screening for ACEs and are more likely to start screening in their practice.