O1001: Aces Screening and Intervention in Pediatric Primary Care: Mid-project Results from the Health Resources and Services Administration (HRSA)-Sponsored Trauma-informed Aces Screening and Intervention Evaluation (TASIE) Project

Purpose/Objectives: In 2021, the Center for Youth Wellness (CYW), a program of Safe & Sound, and the New Jersey Chapter of the American Academy of Pediatrics (NJAAP) received funding from the Health Resources and Services Administration (HRSA) through their Screening and Interventions for Adverse Childhood Experiences in Primary Care Settings Demonstration Project. The project will support 50+ practices through starting or extending an ACEs screening and intervention program. The goal is to yield a model for integrating ACEs screening and intervention into practice using a strengths-based, trauma-informed approach. This model and results of the program will be summarized in a report to Congress in August 2023.

Design/Methods: CYW and the NJAAP will recruit three cohorts of pediatric practices, each nine months in duration, utilizing the Project ECHO® (Extension for Community Healthcare Outcomes) Quality Improvement (QI) framework. This framework will ensure that practices will learn from their peers using the “All Teach, All Learn” method. Each practice will receive a stipend, support through TeleECHO(™) sessions, and coaching calls. Quantitative and qualitative data will be collected at the provider, practice, and patient levels. Data analysis will assess knowledge and behavior change, evaluation of learning, and ease of implementation of the screening process. Process implementation measures include the percentage of patients screened for ACEs, score positive, and that have received the appropriate intervention.

Results: Preliminary results of data of Cohort 1 showed: 16 of the 17 TASIE practices reported screening for ACEs in January and February. During this time the number of eligible patients increased from 24% in January, to 44% in February. 14% of patients screened positive in January and 10 % in February. Per the standardized scoring algorithm used in this project, 64% of patients received patient education in January and 55% in February, and 87% received anticipatory guidance in January and 97% in February.

Conclusion/Discussion: Even at the midpoint in this project, data reveals a positive impact of this approach. Preliminary results show that between January and February, practices increased the number of doctors screening for ACEs, which nearly doubled the number of eligible patients and increased the number of screened patients by 30%. Feedback from the providers demonstrated that devoting more attention to intermediate and higher risk patients and providing anticipatory guidance on the 7 Domains of Wellness as an evidenced-based approach to building resilience can be successfully implemented in a pediatric primary care office.