Adverse Childhood Experiences (ACEs) Screening in Primary Care Settings for Adults: A Systematic Review

Substantial evidence links ACE scores with adult health complications, emphasizing the significance of enhanced detection, interpretation, and management of ACEs in primary care settings for adults. This systematic review aims to explore existing ACE screening and post-screening practices for adult patients in primary care settings worldwide via a thorough systematic review, including a search of PubMed, PsycINFO, and CINAHL databases. Out of an initial 883 potential articles from two independent reviewers, 53 articles met the inclusion and exclusion criteria. Most studies were conducted in the US (71.7%). Globally, 83% of the ACE screening studies indicated that ACES were screened specifically for research purposes, while the remaining 17% covered quality improvement, trauma-informed care interventions, and routine screenings in healthcare settings. This review delves into various intricacies of ACEs screening, the professional roles involved in the screening process, the location where the screening was conducted, prior training on ACEs for the screening implementers, and subsequent actions like interventions, referrals, and resource allocation. Despite growing awareness of the long-term effects of ACEs, a gap exists between ACEs research and related clinical practices in primary care. Additionally, there is no consensus on how to utilize ACEs screening in primary care and which ACE scores necessitate indicated interventions. Implications focus on the collaborative health use of ACEs screenings in primary care.