Recent data from the California Surgeon General’s office shows that pediatricians and primary care providers are rapidly incorporating ACEs screening into their practices. The rationale for screening is strong, with high rates of ACEs identified. Yet providers recognize that in order to reach the goal of reducing ACEs in half we need to build a well-functioning system of follow-up and referrals to relevant resources and specialists. Even though we have tremendous skills in listening to and educating our patients about the impact of ACEs and related life events, we can’t resolve all issues in the primary care setting with close follow-up alone.
Providers should consider developing a treatment plan whenever families reflect motivation to make lifestyle changes or have issues which justify closer follow-up and referral. The ACEs Aware website has a useful basic treatment plan that gives goals and tips for reducing the impact of stress upon families and contact information for national domestic violence, sexual assault and suicide prevention hot lines (See link below). The thresholds for referrals are not well established, however the ACEs Aware risk assessment algorithm recommends that patients at high risk (Score 1-3 with associated health condition or score 4+) should be linked to support services and interventions as appropriate. (See link below).
Photo by Noah Berger, at UCSF Ron Conway Family Gateway. Pictured: Tom Boyce, MD and Lucas Asbury, 7.
