Do pediatricians ask about adverse childhood experiences in pediatric primary care?
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Academic pediatrics
Abstract
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. 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. 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. 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.
Description
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Article
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Keywords
Adverse Childhood Experiences (ACE), Pediatric care, assessment, screening
Citation
Kerker, B. D., Storfer-Isser, A., Szilagyi, M., Stein, R. E., Garner, A. S., O'Connor, K. G., ... & Horwitz, S. M. (2016). Do pediatricians ask about adverse childhood experiences in pediatric primary care?. Academic pediatrics, 16(2), 154-160.