Introduction:The role of adverse childhood experiences (ACEs) in predicting later adverse adult health outcomes is being widely recognized by makers of public policy. ACE questionnaires have the potential to identify in clinical practice unaddressed key social issues that can influence current health risks, morbidity, and early mortality. This study seeks to explore the feasibility of implementing the ACE screening of adults during routine family medicine office visits.Methods: At 3 rural clinical practices, the 10-question ACE screen was used before visits with 111 consecutive patients of 7 clinicians. Clinician surveys about the use of the results and the effect on the visits were completed immediately after the visits. The presence of any ACE risk and "high-risk" ACE scores (>4) were compared with clinician survey responses.Results: A risk of ACEs was present in 62% of patients; 22% had scores >4. Clinicians were more likely to have discussed ACE issues for high-risk patients (score 0 -3, 36.8%; score >4, 83.3%; P .؍ 00). Clinicians also perceived that they gained new information (score 0 -3, 35.6%; score >4, 83.3%; P ؍ .00). Clinical care changed for a small proportion of high-risk patients, with no change in immediate referrals or plan for follow-up. In 91% of visits where a risk of ACEs was present, visit length increased by <5 minutes.
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