# An Assessment of Harm in Adults—Adverse Childhood Experiences Screening in Primary Care: A Survey-Based Study

## TL;DR

This study explores how adults in primary care feel about being screened for childhood trauma and finds that most are comfortable with the process.

## Contribution

The study provides new insights into the feasibility and patient experience of ACE-Q screening in adult primary care settings.

## Key findings

- 81% of participants reported at least one adverse childhood experience.
- 82% felt comfortable discussing childhood stress with their healthcare provider.
- Higher ACE scores correlated with increased discomfort and interest in learning about ACEs.

## Abstract

The Adverse Childhood Experiences Questionnaire (ACE-Q) screens for adverse childhood experiences (ACEs), which are linked to increased disease risk. Although pediatric studies report no adverse effects of ACE-Q use, primary care data is limited. This study examined adult patients’ experiences with ACE-Q screening in primary care. Adults (18+) at a primary care center in London, Ontario, completed the ACE-Q and a follow-up questionnaire evaluating ACE screening experience. Correlations assessed relationships between ACE-Q scores and follow-up responses. Among 260 participants, 81% reported at least one ACE. Most (82%) felt comfortable discussing stressful childhood experiences with their healthcare provider. Higher ACE scores were associated with increased discomfort (rs = −0.166, P = 0.007), feeling upset by the ACE-Q (rs = 0.173, P = 0.005), and greater interest in learning about ACEs (rs = 0.177, P = 0.004). Overall, ACE-Q screening in primary care was generally well-received, with most patients recognizing its relevance despite some discomfort. These findings highlight the potential for integrating ACE screening into routine primary care to address long-term health risks. Further research is needed to confirm findings and optimize screening practices.