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Current state of screening high-ACE youth and emerging adults in primary care

Pardee, Michelle DNP, FNP-BC (Clinical Assistant Professor); Kuzma, Elizabeth DNP, FNP-BC (Clinical Assistant Professor); Dahlem, Chin Hwa (Gina) Y. PhD, FNP-C, FAANP (Clinical Assistant Professor); Boucher, Nicole PhD, CPNP (Clinical Assistant Professor); Darling-Fisher, Cynthia S. PhD, FNP-BC (Clinical Associate Professor)

Journal of the American Association of Nurse Practitioners: December 2017 - Volume 29 - Issue 12 - p 716–724
doi: 10.1002/2327-6924.12531

Background and purpose: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma. A review of current assessment tools used in assessing this population in health settings is needed to determine how screening for ACEs is being performed.

Conclusions: Clinically efficient tools for screening and assessment of high-ACE youth in primary care settings are lacking. Developing a process to assess ACEs, risk behaviors, and physical and mental health status that is efficient to use during a time limited clinical visit is an important step in providing holistic care to a challenging population.

Implications for practice: Primary care NPs are in the perfect position to implement assessments of ACEs through trauma-informed nursing care. ACE assessment in clinical practice will provide vital information to guide the development of tailored interventions for reducing risk behaviors and mitigate the long-term impacts of ACEs.

Health Behavior and Biological Sciences, The University of Michigan School of Nursing, Ann Arbor, Michigan


Michelle Pardee, DNP, FNP-BC, The University of Michigan School of Nursing, 426 N. Ingalls, #4130, Ann Arbor, MI 48109. Tel: 734-647-0132; Fax: 734-763-3455; E-mail:,

Received: 4 May 2017; revised: 17 September 2017; accepted: 1 October 2017

© 2017 American Association of Nurse Practitioners
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