• J Am Board Fam Med · Mar 2024

    Disparities in Screening for Adverse Childhood Experiences.

    • Héctor E Alcalá, Amanda E Ng, Nicholas Tkach, Dahai Yue, and Mienah Sharif.
    • From the Department of Behavioral and Community Health, University of Maryland, College Park, College Park, MD (HEA), University of Maryland, College Park, Department of Epidemiology and Biostatistics, College Park, MD (AEN), New York Institute of Technology, Old Westbury, New York (NT), University of Maryland, College Park, Department of Health Policy and Management, College Park, MD (DY), University of Washington, Seattle, Department of Epidemiology, Hans Rosling Center for Population Health, Seattle, WA (MS). hectorapm@ucla.edu.
    • J Am Board Fam Med. 2024 Mar 11; 37 (1): 738373-83.

    IntroductionScreening for adverse childhood experiences (ACEs) in the clinical setting is set to become more commonplace with continued efforts to reimburse clinicians for screening. However, an examination of disparities in ACEs screening and related attitudes and beliefs is needed.MethodsUsing the 2021 California Health Interview Survey (CHIS), this study examined if several measures of socioeconomic status, access to care and identities were associated with 3 outcomes: 1) getting screened for ACEs by a clinician; 2) beliefs about the importance of screening and 3) satisfaction with efforts to address the impacts of ACEs. Logistic regressions were used to estimate odds of the outcomes.ResultsBlack, Latinx, and Asian individuals had lower odds of being screened for ACEs than non-Hispanic Whites. A recent doctor's visit, higher burden of ACEs, and serious psychological distress were associated with higher odds of being screened. Latinx individuals, women, bisexual individuals, those with a recent doctor's visit and those with serious psychological distress had higher odds of believing clinicians asking about ACEs was very important, relative to their counterparts. Latinx individuals, American Indian or Alaska native individuals, Asian individuals, those with higher educational attainment and those with serious psychological distress had lower odds of being very satisfied with providers' efforts to address the impact of ACEs, relative to their counterparts.ConclusionsEfforts to expand ACEs screening should consider the disparities in screening that currently exist. Given the wide-ranging impacts that ACEs have on health, an equitable approach to screening is necessary.© Copyright 2023 by the American Board of Family Medicine.

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