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Background Adverse childhood experiences (ACEs) are associated with adult high-risk behaviors and diseases. There is value in screening parents for ACEs given the repercussions parental ACEs may have on parenting behaviors and child development. The primary aim of this study was to assess the feasibility of parental ACE screening in the home setting. A secondary aim was to evaluate whether or not maternal ACEs correlated with maternal mental health measures. Methods Two home visiting programs that support early childhood development and conduct parental mental health screening implemented ACE screening for parents of infants < 1 year of age. Descriptive statistics were produced for population surveillance of ACEs as well as standard-practice screens for depression, anxiety, substance use, and intimate partner violence. Logistic models were used to examine associations between ACE score and mental health measures. Results A total of 110 parents completed the ACE screen. All possible ACE score outcomes were represented (0–10). A trend toward association of positive prenatal maternal depression screen with ACE score was identified (p=0.05). Conclusion This novel prospective home-based screening program for parental ACEs was feasible and identified a trend toward increasing ACE score association with positive prenatal maternal depression screen.

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The objective of this quality evaluation was to evaluate the changes in public health nursing (PHN) interventions after the implementation of an evidence-based family home visiting (eB-fHV) guideline encoded using the Omaha System. Design and sample: This quality improvement evaluation was conducted using a secondary dataset of 27,910 PHN family home visiting interventions from visits to 129 adult clients enrolled in eB-fHV programs in a Midwestern PHN agency. The interventions were documented 12 months before and 14 months after eB-fHV Guideline implementation. The eB-fHV consisted of 94 PHN interventions for 10 Omaha System problems, with electronic health record (eHr) data generated by PHNs during routine clinical documentation. Standard descriptive and inferential statistics were employed in the analysis. Measures: The Omaha System was used to compare PHN practice before and after the guideline implementation. Results: Documentation patterns revealed that PHNs tailored interventions while also shifting toward the use of the eB-fHV guideline interventions. Ten eB-fHV problems accounted for 96.3% of interventions documented before and 98.5% of interventions documented after implementation. The proportion of interventions before and after eB-fHV by problem differed significantly for all problems except Substance use. fewer interventions were provided after eB-fHV for the primary problems of Pregnancy and Postpartum, with a shift to more interventions for caretaking/parenting. Conclusion: The PHN documentation demonstrated an adherence to the eB-fHV guideline, while tailoring the evidence-based interventions differentially by problem. further research is needed to extend this quality improvement approach to other guidelines and populations.