OBJECTIVE:Previous work has highlighted associations between Adverse Childhood Experiences (ACEs) and mental health care use, but few studies use nationally representative data self-reported by teenagers. METHODS:Data came from the cross-sectional National Health Interview Survey (NHIS)- Teen (July 2021-December 2023), an online follow-back survey of teenagers whose parents answered the child portion of the main NHIS. Multivariate logistic regression models estimated associations between selected ACEs and a summed ACEs score (four or more ACEs vs. three or less), and mental health care use in the past 12 months: 1) took prescription medication, 2) received therapy, and 3) unmet mental health care need due to 4) cost, 5) stigma, and 6) not knowing where to go, among teenagers aged 12-17 (N = 1677). RESULTS:One-tenth of teenagers (11.5%) had four or more selected ACEs. Around 15.2% of teenagers took prescription medication for their mental health in the past 12 months, while 18.7% received therapy. Having four or more ACEs (adjusted prevalence ratio, APR: 1.43, 95% confidence interval, CI: 1.02-2.01), being a victim or witnessing violence in the neighborhood (APR: 1.41, 95% CI: 1.06-1.88), experiencing emotional abuse (APR: 1.50, 95% CI: 1.12-2.02), and experiencing racism (APR: 1.46, 95% CI: 1.10-1.94) were related to taking prescription medication. Most selected ACEs were related to higher prevalence of receiving therapy (eg, household mental illness, APR:1.97; 95% CI: 1.50-2.58). CONCLUSIONS:ACEs were related to greater use of mental health care and selected barriers for unmet mental health care need. Future work may examine the underlying mechanisms of these associations.

INTRODUCTION:Screening for adverse childhood experiences (ACEs) in the clinical setting is set to become more commonplace with continued efforts to reimburse clinicians for screening. However, an examination of disparities in ACEs screening and related attitudes and beliefs is needed.METHODS:Using the 2021 California Health Interview Survey (CHIS), this study examined if several measures of socioeconomic status, access to care and identities were associated with 3 outcomes: 1) getting screened for ACEs by a clinician; 2) beliefs about the importance of screening and 3) satisfaction with efforts to address the impacts of ACEs. Logistic regressions were used to estimate odds of the outcomes.RESULTS:Black, Latinx, and Asian individuals had lower odds of being screened for ACEs than non-Hispanic Whites. A recent doctor's visit, higher burden of ACEs, and serious psychological distress were associated with higher odds of being screened. Latinx individuals, women, bisexual individuals, those with a recent doctor's visit and those with serious psychological distress had higher odds of believing clinicians asking about ACEs was very important, relative to their counterparts. Latinx individuals, American Indian or Alaska native individuals, Asian individuals, those with higher educational attainment and those with serious psychological distress had lower odds of being very satisfied with providers' efforts to address the impact of ACEs, relative to their counterparts.CONCLUSIONS:Efforts to expand ACEs screening should consider the disparities in screening that currently exist. Given the wide-ranging impacts that ACEs have on health, an equitable approach to screening is necessary.

Little is known about the impact of adverse childhood experiences (ACEs) on delaying health care. Using data from the 2016-2017 National Survey of Children's Health (n = 64,103), we examined the association between ACEs and forgoing: medical care, hearing care, vision care, mental health care, and use of health services. In logistic regression models, cumulative ACEs were associated with increases in forgoing most types of care. ACEs were associated with increased odds of using emergency department services and preventative health care. Efforts must be undertaken to reduce delays in care among children with a history of ACEs.

Adverse Childhood Experiences (ACEs) include experiences of child maltreatment and household dysfunction. Prior work has shown that children with ACEs may have suboptimal utilization of preventive health care, including annual well-visits, however little is known about the relationship between ACEs and quality of patient care. Using data from the 2020 National Survey of Children's Health (N = 22,760) a series of logistic regression models estimated associations between ACEs, both individually and cumulatively, and five components of family-centered care. Most ACEs were consistently associated with lower odds of family-centered care (e.g. financial hardship was associated with doctors always spend enough time with children, AOR = 0.53; 95% CI = 0.47, 0.61), except for having a parent or guardian die, which was associated with higher odds. Cumulative ACE score was also associated with lower odds of family-centered care (e.g. doctors always listened carefully to the parent, AOR = 0.86; 95% CI = 0.81, 0.90). These findings emphasize the importance of the consideration of ACEs in the context of family-centered care, and support the need for ACEs screening in the clinical setting. Future work should focus on mechanisms explaining the observed associations.

BACKGROUND:To date, there is limited literature on the relationship between Adverse Childhood Experiences (ACEs) and the quality of health care provider encounters. This is key, as people with a history of ACEs have a greater burden of illness. METHODS:This study uses data from the 2020-2021 National Survey of Children's Health to examine relationships between ACEs and (1) spending less than ten minutes with a health care provider, and (2) spending time alone with a health care provider. RESULTS:In general, our results suggested most ACEs were associated with higher odds of a provider spending <10 min with a child during their last preventative care visit, while ACEs were inconsistently related to spending time alone with a provider. Each additional ACE was found to be associated with higher odds of both outcomes. CONCLUSIONS:This work emphasizes the importance of ACEs screening in a health care setting and may set the groundwork for future research investigating mechanisms within these associations. Given the established link between health care quality and patient-provider trust, and health outcomes, intervention work is needed to develop healthcare practices that may encourage the length and quality of health care provider visits.

New York Institute of Technology College of Osteopathic Medicine Old Westbury, NY [email protected] Department of Psychiatry New Jersey Medical School; Consult Liaison Service University Hospital Newark, NJ Received February 6, 2023; accepted after revision May 13, 2023.

Objectives: To examine the relationship between Adverse Childhood Experiences (ACEs) and utilization and delay of dental care among children. Methods: Using data from the 2018-2019 National Survey of Children's Health (n 1/4 53,963) we examined the association between ACEs and 1) dental health; 2) use of dental care; 3) use of preventive dental care; 4) delaying needed dental care. Logistic regressions were used to calculate odds of each outcome, with nine ACEs and the cumulative number of ACEs as the independent variables each in separate models. Results: After accounting for confounders, most ACEs were associated with higher odds of having poorer dental health. Similarly, most ACEs were associated with lower odds of using dental care and higher odds of delaying needed dental care. Conclusions: This study expands the research showing a deleterious impact of ACEs on utilization of health care by showing that dental care is also adversely impacted. Efforts must be undertaken to improve access to dental care for children with a history of ACEs. (c) 2022 Japanese Society of Pediatric Dentistry. Published by Elsevier Ltd. All rights reserved.

An experiential interprofessional learning opportunity for university students was developed to demonstrate core competencies (CC) based on the Interprofessional Education Collaborative and to foster a deeper understanding of the interaction between literature, health care, and social justice. Faculty members in the Schools of Professional Development, Public Health, Medicine, and Social Welfare at Stony Brook University contributed to the program including use of the book, The Immortal Life of Henrietta Lacks by Rebecca Skloot (2010). The book was a springboard to combine John Dewey's educational ideas of constructivist learning with select CC. Invitations for participation were extended to faculty and students enrolled in graduate programs in Teaching, Public Health, Medicine, Social Work, and Physician Assistant Education as well as undergraduate health science majors. The ultimate learning event was a 4-hour evening program that facilitated teamwork and collaboration among the 250 participants. The event presented information and context in multiple ways: The book inspired an innovative presentation, followed by pointed questions, discussion, problem solving and reflection. Topics explored included communication across cultures and diverse populations, privacy and patient rights, professional roles and responsibilities, and advocacy for self and others. Following the event course, instructors collected post-event reflective essays submitted by the master of public health student participants, which were analyzed using qualitative methods. This article describes the experiential learning program and the evaluation of its impact on students, with the purpose of enhancing the potential for other institutions to replicate this novel educational structure and achieve Interprofessional Education Collaborative CC.