We’re pleased to share our new publication in Frontiers in Public Health, exploring how California’s standardized childhood ACEs screening efforts are being implemented in everyday clinical practice.
In 2020, California introduced ACEs Aware, becoming the first state to support and reimburse structured screenings for early life challenges across the Medi-Cal program. The objective is to help providers recognize potential patterns in patient history that could impact future health and behavior outcomes and inform clinical decision-making.
Our study surveyed clinicians across the state to better understand how this screening initiative is being carried out in everyday settings, what aspects appear to be helpful, what makes screening work in different settings, and where obstacles still exist.
Key takeaways from providers:
- There is growing interest in broadening patient care models to emphasize comprehensive wellness and support families into the future rather than focusing only on present concerns.
- Many California providers are consistently using the state-sponsored Pediatric ACEs and Related Life Events Screener (PEARLS) tool for structured screenings.
- Implementation is feasible, though common hurdles include limited staffing and tight appointment schedules.
- Some clinicians expressed uncertainty about appropriate next steps when a child presents with multiple ACEs indicators, thus indicating a potential need for more work to understand the right role for the health system related to ACEs.
- Institutional support and reimbursement policies will likely contribute to sustainability, though potential unintended consequences, such as drawing resources away from other groups more effective at responding to ACEs issues, are important to take into consideration.
This research was conducted in partnership with colleagues from UC San Diego, the California Chapter of the American Academy of Pediatrics, and Boston University.
Read the full study here.