Evidence-Based Education on Adverse Childhood Experiences Screening for Behavioral Health Care Providers

Abstract

Purpose: This quality improvement (QI) project aimed to increase behavioral health medical professional (BHMP) knowledge on appropriate adverse childhood experience (ACE) screening and utilization of measurement-based care (MBC) principles by developing an educational session demonstrated through a clinical vignette. Background: At an outpatient behavioral health clinic, the clinical interview remains the primary ACE assessment method. This site currently lacks an evidence-based practice for ACEs screening. Exposure to early-life adversity produces prolonged brain changes and is correlated with developing diabetes, heart disease, post-traumatic stress disorder, and asthma. Childhood trauma symptoms mimic multiple common psychiatric conditions and are often missed in a psychiatric evaluation. MBC uses standardized screening tools to monitor patient symptoms and has improved patient outcomes in various populations and clinical settings. Educating clinicians on evidence-based trauma screening can be beneficial in promoting a trauma-informed culture where widespread trauma is recognized, and providers respond without further escalation or re-traumatization. Methods: This QI project used a quasi-experimental pretest and posttest design with an educational PowerPoint presentation demonstrating an MBC approach to ACE screening. Fifteen BHMPs were recruited through convenience sampling, and participants completed pre- and post-intervention surveys that assessed appropriate ACEs screening knowledge, standardized measurement use, and feasibility. Descriptive statistics were used to analyze and interpret the survey data. Results: Six of the eleven participants completed the pretest and posttest intervention survey. Following the educational presentation, project data revealed that knowledge scores for all participants improved on the posttest. The posttest survey data indicated that five providers did not have adequate training on standardized measures. Encouraging findings from data analysis include 83% of participants agreeing the educational presentation increased their comfort level in assessing childhood trauma symptoms, considering standardized measures worth the time of administration, and believing MBC principles improve diagnostic accuracy. Conclusions: Educating behavioral health providers about current evidence for appropriate ACEs screening increase knowledge and comfort post-educational session. Effective ACEs screening protocols provided objective targets for early intervention and treatment of childhood trauma. Improving BMHPs’ ACEs screening clinical knowledge can help ensure patients receive personalized trauma treatment based on measurable patient outcomes.