Current state of screening high-ACE youth and emerging adults in primary care

J Am Assoc Nurse Pract. 2017 Dec;29(12):716-724. doi: 10.1002/2327-6924.12531. Epub 2017 Nov 15.


Background and purpose: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed.

Conclusions: Clinically efficient tools for screening and assessment of high-ACE youth in primary care settings are lacking. Developing a process to assess ACEs, risk behaviors, and physical and mental health status that is efficient to use during a time limited clinical visit is an important step in providing holistic care to a challenging population.

Implications for practice: Primary care NPs are in the perfect position to implement assessments of ACEs through trauma-informed nursing care. ACE assessment in clinical practice will provide vital information to guide the development of tailored interventions for reducing risk behaviors and mitigate the long-term impacts of ACEs.

Keywords: Adolescents; assessment; primary care; screening; trauma.

MeSH terms

  • Adult
  • Humans
  • Life Change Events*
  • Mass Screening / methods*
  • Mass Screening / psychology
  • Mass Screening / trends*
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Primary Health Care / trends
  • Risk-Taking