Other Titles

Rising Star Poster/Presentation - Rapid Presentation Round

Abstract

Objective: Adverse Childhood Experiences (ACEs) are associated with physical and mental health conditions and linked to chronic health conditions among adults who have experienced trauma or toxic stress. ACEs are associated with severe health and social difficulties among children and adults, such as low productivity, mental health, substance abuse, chronic diseases, and short life expectancy. One in four children in the U.S. between the ages of 12 and 17 has at least experienced two or more ACEs. ACEs are more prevalent among underserved and ethnic minority groups. Immigrant children are affected more than non-immigrants; 42% of Hispanic children have higher ACEs than 36% of non-Hispanic white children. Providing early ACEs screening for children leads to early identification of ACEs and improvement of physical and mental health outcomes through early intervention. Screening for ACEs could help prevent 1.9 million cardiovascular-related cases and 21 million depression cases among patients This project implemented ACEs screening for children at a school-based community clinic with a large immigrant population and evaluate the impact of early screening, risk identification, interventions, and referrals to mental health providers.

Method: The Center for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW ACE-Q) was used for patients between 0-19 years old. Parents or caregivers completed screening questionnaires for children aged 0 to 12 or 13 to 19 who could not complete the screening. Adolescents ages 13-19 completed the self-report ACE screening for teens. Healthcare providers verified completion and discussed ACEs score results with the patients, parents, or caregivers. Mental health services referrals were made for patients with positive ACEs scores. Pre- and post-implementation surveys assessed stakeholders' (health care providers, social work students, and clinic staff) knowledge of ACEs and the screening process.

Results: During the 16-week implementation, 87% of children at the clinic were screened for ACEs (N=138). Out of the 138 patients screened for ACEs, 20% (n=28) of the children had positive ACEs scores of 4 or more, which indicates that 20% of children with positive ACE scores had a score of 4 or more. Twenty of twenty-eight patients with positive ACEs scores were children of immigrants or from minority groups. Mental health referrals were made for all positive screenings.

Conclusion: ACE screening using the CYW ACE-Q tool was an effective and feasible way for a clinic to identify children with an increased risk for trauma, toxic stress, and physical and mental health and provide an early referral to mental health services and community resources. Early identification of intermediate-risk children and those with positive ACEs promotes early interventions, which can significantly reduce long-term physical and mental health illness among children.

Notes

References:   Center for Disease Control and Prevention (2022, April 6). Violence prevention: Adverse childhood experiences https://www.cdc.gov/violenceprevention/aces/prevention.html

Marsicek, S. M., Morrison, J. M., Manikonda, N., O’Halleran, M., Spoehr-Labutta, Z., & Brinn, M. (2019). Implementing Standardized Screening for Adverse Childhood Experiences in a Pediatric Resident Continuity Clinic. Pediatric Quality & Safety, 4(2), e154–e154. https://doi.org/10.1097/pq9.0000000000000154

Mersky, J. P., Choi, C., Lee, C. P., & Janczewski, C. E. (2021). Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: Intersectional analysis of a nationally representative sample. Child Abuse & Neglect, 117, 105066

Sacks, V., & Murphey, D. (2018). The prevalence of adverse childhood experiences, nationally, by state, and by race or ethnicity. Child trends, 20, 2018. https://www.childtrends.org/publications/prevalence-adverse-childhood-experiences-nationally-state-race-ethnicity

Soleimanpour, S., Navarro, S., & Brindis, C. D. (2021). Addressing the unique needs of immigrant youth. https://www.acesaware.org/wp-content/uploads/2021/12/Screening Adolescents-for-ACEs-Addressing-the-Unique-Needs-of-Immigrant-Youth.pdf

Description

Adverse childhood experience ( ACEs) are associated with physical and mental health. One in four children in the U.S. between the ages of 12 and 17 has at least experienced two or more ACEs. ACEs are more prevalent among underserved, racial or ethnic minority groups.

Author Details

Felicia Vanessa Zimmerman, BSN, RN, DNP student

Sigma Membership

Non-member

Type

Poster

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Adverse Childhood Experiences, Medical Screening, Immigrant Families, Immigrants

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Washington, DC, USA

Conference Year

2024

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Event Material, Invited Presentation

Acquisition

Proxy-submission

Date of Issue

2026-03-10

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Improving Immigrant Families Health: Screening for Adverse Childhood Experiences

Washington, DC, USA

Objective: Adverse Childhood Experiences (ACEs) are associated with physical and mental health conditions and linked to chronic health conditions among adults who have experienced trauma or toxic stress. ACEs are associated with severe health and social difficulties among children and adults, such as low productivity, mental health, substance abuse, chronic diseases, and short life expectancy. One in four children in the U.S. between the ages of 12 and 17 has at least experienced two or more ACEs. ACEs are more prevalent among underserved and ethnic minority groups. Immigrant children are affected more than non-immigrants; 42% of Hispanic children have higher ACEs than 36% of non-Hispanic white children. Providing early ACEs screening for children leads to early identification of ACEs and improvement of physical and mental health outcomes through early intervention. Screening for ACEs could help prevent 1.9 million cardiovascular-related cases and 21 million depression cases among patients This project implemented ACEs screening for children at a school-based community clinic with a large immigrant population and evaluate the impact of early screening, risk identification, interventions, and referrals to mental health providers.

Method: The Center for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW ACE-Q) was used for patients between 0-19 years old. Parents or caregivers completed screening questionnaires for children aged 0 to 12 or 13 to 19 who could not complete the screening. Adolescents ages 13-19 completed the self-report ACE screening for teens. Healthcare providers verified completion and discussed ACEs score results with the patients, parents, or caregivers. Mental health services referrals were made for patients with positive ACEs scores. Pre- and post-implementation surveys assessed stakeholders' (health care providers, social work students, and clinic staff) knowledge of ACEs and the screening process.

Results: During the 16-week implementation, 87% of children at the clinic were screened for ACEs (N=138). Out of the 138 patients screened for ACEs, 20% (n=28) of the children had positive ACEs scores of 4 or more, which indicates that 20% of children with positive ACE scores had a score of 4 or more. Twenty of twenty-eight patients with positive ACEs scores were children of immigrants or from minority groups. Mental health referrals were made for all positive screenings.

Conclusion: ACE screening using the CYW ACE-Q tool was an effective and feasible way for a clinic to identify children with an increased risk for trauma, toxic stress, and physical and mental health and provide an early referral to mental health services and community resources. Early identification of intermediate-risk children and those with positive ACEs promotes early interventions, which can significantly reduce long-term physical and mental health illness among children.