# Advocating for Our Children: An Initiative Utilizing Verbal and Video Education to Increase Adverse Childhood Experiences Questionnaire Form Response Rate

## TL;DR

This study shows that using verbal and video education can boost response rates to a questionnaire that identifies childhood experiences linked to future health risks.

## Contribution

The novel contribution is demonstrating the effectiveness of verbal and video education in increasing ACE-Q response rates in clinical settings.

## Key findings

- Educational interventions significantly increased ACE-Q response rates in two PDSA cycles.
- The second PDSA cycle showed a large jump in response rates from 15% to 45.2%.
- Verbal and video education models are effective for improving ACE-Q completion rates.

## Abstract

Negative experiences in childhood, Adverse Childhood Experiences, significantly increase the risk of adverse health outcomes in adulthood. Obtaining a better understanding of the experiences a child has been through during development allows providers to connect them with resources to improve health outcomes.

We performed problem identification via PubMed and the Florida Department of Health web page. We used the plan-do-study-act (PDSA) quality improvement method. Intervention one involved teaching clinic staff about distributing the Adverse Childhood Experiences Questionnaire (ACE-Q) form during well-check visits. Intervention two involved a video education tool to explain the purpose and importance of the ACE-Q to caretakers. We conducted a retrospective chart review at the 17 Davis and HealthPark clinics 3 months preceding each PDSA cycle. We analyzed the data to assess the response rate to the ACE-Q before and after each cycle.

The educational initiatives increased the response rate to the ACE-Q form in both PDSA cycles. The ACE-Q was significantly more likely to be filled out after the first (19.2% in pre versus 24.8% in post, P < 0.001) and second PDSA cycles (15% in pre versus 45.2% in post, P < 0.001).

Verbal and video education models can increase the response rate to the ACE-Q. Response collection is valuable for identifying and supporting patients at the highest risk for poor health outcomes. Future studies would benefit from addressing low view counts on video interventions, standardizing ACE-Q score assessment, and implementing sustainable measures.