Abstract
Objective
The stress associated with adverse childhood experiences (ACEs) has immediate and
long-lasting effects. The objectives of this study were to examine 1) how often pediatricians
ask patients' families about ACEs, 2) how familiar pediatricians are with the original
ACE study, and 3) physician/practice characteristics, physicians' mental health training,
and physicians' attitudes/beliefs that are associated with asking about ACEs.
Methods
Data were collected from 302 nontrainee pediatricians exclusively practicing general
pediatrics who completed the 2013 American Academy of Pediatrics Periodic Survey.
Pediatricians indicated whether they usually, sometimes, or never inquired about or
screened for 7 ACEs. Sample weights were used to reduce nonresponse bias. Weighted
descriptive and logistic regression analyses were conducted.
Results
Only 4% of pediatricians usually asked about all 7 ACEs; 32% did not usually ask about
any. Less than 11% of pediatricians reported being very or somewhat familiar with
the ACE study. Pediatricians who screened/inquired about ACEs usually asked about
maternal depression (46%) and parental separation/divorce (42%). Multivariable analyses
showed that pediatricians had more than twice the odds of usually asking about ACEs
if they disagreed that they have little effect on influencing positive parenting skills,
disagreed that screening for social emotional risk factors within the family is beyond
the scope of pediatricians, or were very interested in receiving further education
on managing/treating mental health problems in children and adolescents.
Conclusions
Few pediatricians ask about all ACEs. Pediatric training that emphasizes the importance
of social/emotional risk factors may increase the identification of ACEs in pediatric
primary care.
Keywords
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Article Info
Publication History
Published online: August 07, 2015
Accepted:
August 1,
2015
Received:
May 28,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Moving From Social Risk Assessment and Identification to Intervention and TreatmentAcademic PediatricsVol. 16Issue 2
- PreviewClinical care seeks to match the right patient to the right treatment. Clinicians use histories and physicals to guide assessment and to determine diagnosis and management plans. This pattern of assessment, identification, and treatment typically focuses on symptoms and diseases. However, mounting evidence suggests that social determinants of health (SDH) may be just as, if not more, relevant to clinical outcomes than many of the medical or biologic determinants that often dominate our focus. It is therefore natural to consider how we might reliably and effectively integrate assessment, identification, and treatment of the SDH into clinical practice.
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