Knowledge and perceptions of ACES (Adverse Childhood Experiences) among parents and providers in Northeast Tennessee

Background: Adverse Childhood Experiences (ACEs) are a risk factor for the development of future physical and mental health problems. Programs are needed that prevent and address the impact of ACEs on a population-based level. As a pediatric primary care clinic serving Northeast Tennessee, our goal was to better understand the knowledge and perceptions of the effects of ACEs among parents/caregivers and health professionals in Northeast Tennessee. Methods: During the summer of 2017, 51 parents/caregivers visiting a health education table at a family event in a local public library completed an anonymous survey to help us understand what people think about how ACEs affect children and adults. 20 health care professionals at a local pediatric primary care clinic completed the same anonymous survey. Survey results were entered into Excel and analyzed using Excel and SPSS. Results: Fewer than one-third of parents/caregivers in this sample had heard of the term ACEs prior to receiving this survey. However, after being provided with a definition of ACEs, most respondents agreed that ACEs could affect children\u27s behavior and adult mental health. Agreement was less for perceptions of effects on physical health in adults. Most respondents recognized that a parent’s own ACE exposure could make parenting more difficult and that having a strong support system is helpful in counteracting these negative effects. Healthcare providers were more likely than parents/caregivers to have heard of the term ACEs before, however only half were familiar with the term. After being provided with a definition of ACEs, most healthcare providers agreed on their effects on children and adults. Perceptions that having a strong support system could counteract the effects of ACEs were slightly lower among health care providers as compared to parents/caregivers. Conclusion: The low awareness of ACEs found by our survey confirms the need for a new initiative to screen for ACEs and provide trauma-informed care in our clinic. The project, Baby Steps for Success, will involve screening children and parents/caregivers for ACEs, providing brief education on ACEs, and building resilience. Engaging and supporting families around healthy behaviors and interactions will be accomplished using Reach Out and Read and ReadNPlay for a Bright Future beginning in early infancy. Intervention with the Incredible Years program and Ecomap assessments will be provided to high-risk families with 2 or more ACEs. Families with four or more ACEs will be offered the Nurturing Parenting curriculum through a series of home and group visits. Partners for this project will include ETSU Pediatrics, Families Free, and the Northeast TN Regional Health Office