Screening for Adverse Childhood Experiences in a Family Medicine Setting: A Feasibility Study

Patricia T. Glowa; Ardis L. Olson; Deborah J. Johnson

doi:10.3122/jabfm.2016.03.150310

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Table 1.

Patient-Reported Adverse Childhood Experiences Questionnaire Responses, Item Responses, and Score Distribution for Any Risk Response and ≥4 Risks, by Sex

	Respondents (%)			P Value^{^†}
	Men (n = 37)	Women (n = 67)	Total (n = 111^*)	P Value^{^†}
Abuse
While you were growing up, during your first 18 years of life, a parent or other adult in the household often or very often:
Swore at you, insulted you, put you down, or humiliated you, OR acted in a way that made you afraid that you might be physically hurt.	24.3	23.5	22.5	.63
Pushed, grabbed, slapped, or threw something at you, OR ever hit you so hard that you had marks or were injured.	21.6	16.2	18	.50
Touched or fondled you or had you touch their body in a sexual way, OR attempted or actually had oral, anal, or vaginal intercourse with you.	8.37	25	20	.11
Neglect
While you were growing up, during your first 18 years of life, you often or very often felt that:
No one in your family loved you or thought you were important or special, OR your family didn't look out for each other, feel close to each other, or support each other.	18.9	23.5	20.7	.58
You didn't have enough to eat, had to wear dirty clothes, and had no one to protect you, OR your parents were too drunk or high to take care of you or take you to the doctor if you needed it.	8.1	7.5	7.2	.87
Household dysfunction
While you were growing up, during your first 18 years of life:
Your parents were ever separated or divorced.	37.8	26.5	29.7	.25
Your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her, OR sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard, OR was very repeatedly hit for at least a few minutes or threatened with a gun or knife.	2.7	4.4	3.6	.85
You lived with someone who was a problem drinker or alcoholic or who used street drugs.	35.1	25	27.9	.30
A household member was depressed or mentally ill, OR a household member attempted suicide.	24.3	32.4	27.9	.37
A household member went to prison.	8.1	4.4	5.4	.67
Total ACE score
Any ACE risk (score ≥1)	59.5	64.7	62.0	.51
High ACE risk (score ≥4)	24.3	22.1	22.0	.62

Data were collected during nonacute primary care visits in 2015.
↵* Seven subjects did not provide a response for gender.
↵† χ² test.
ACE, Adverse Childhood Experiences.

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Table 2.

Clinician Responses on the After-Visit Survey (n = 111) Collected After Adverse Childhood Experiences Screening

	ACE Risk Level
	0 (n = 42)	≥1 (n = 69)	P Value	0–3 (n = 87)	≥4 (n = 24)	P Value^*
This patient's ACE survey results:
Provided new information	2 (4.8)	49 (71.0)	.00	31 (35.6)	20 (83.3)	.00
Changed my clinical care	0 (0)	4 (5.8)	.11	0 (0)	4 (16.7)	.002
Changed plan for follow-up with me	0 (0)	1 (1.4)	.43	1 (1.1)	0 (0)	.60
Changed the referrals made today	0 (0)	0 (0)	—	0 (0)	0 (0)	—
Issues detected on the ACE were discussed during the visit	6 (14.3)	47 (68.1)	.00	32 (36.8)	20 (83.3)	.00
Additional time added to visit (minutes)
0–3	42 (100)	44 (63.8)	.00	77 (88.5)	9 (37.5)	.00
3–5	0 (0)	19 (27.5)		10 (11.5)	9 (37.5)
5–10	0 (0)	4 (5.8)		0 (0)	4 (16.7)
10–15	0 (0)	2 (2.9)		0 (0)	2 (8.3)
>15	0 (0)	0 (0)		0 (0)	0 (0)