Table 3.
Phone Survey Responses Among Patients Who Completed the Adverse Childhood Experiences Screening, by Adverse Childhood Experience Score (N = 210)
| Question | Responses | Overall % | 0 ACEs % | 1–2 ACEs % | 0 vs. 1–2 pa | 3+ ACEs | 0 vs. 3+ pa |
|---|---|---|---|---|---|---|---|
| 1. During your most recent prenatal visit, did you complete a questionnaire that asked about things that might have happened in your family when you were a child, such as divorce, abuse, domestic violence, or mental illness? | Yes | 93.7 | 93.2 | 93.2 | 0.33 | 95.5 | 0.64 |
| No | 3.9 | 4.9 | 1.7 | 4.5 | |||
| Not sure | 2.4 | 1.9 | 5.1 | 0.0 | |||
| 2. How comfortable were you answering the questions? | Very comfortable | 62.6 | 76.3 | 60.0 | 0.04b | 34.9 | <0.001 |
| Somewhat comfortable | 28.7 | 16.5 | 34.6 | 48.8 | |||
| Somewhat uncomfortable | 8.2 | 7.2 | 5.5 | 14.0 | |||
| Very uncomfortable | 0.5 | 0.0 | 0.0 | 2.3 | |||
| 3. Did your healthcare clinician: | |||||||
| a. Review the questionnaire with you? | Yes | 55.8 | 48.0 | 69.0 | 0.02b | 55.8 | 0.66b |
| No | 30.2 | 37.8 | 17.2 | 30.2 | |||
| Not sure | 14.1 | 14.3 | 13.8 | 14.0 | |||
| b. Ask about or talk with you about things that happened when you were a child? | Yes | 36.5 | 26.0 | 47.4 | 0.009 | 46.7 | 0.01 |
| No | 59.1 | 71.2 | 47.5 | 46.7 | |||
| Not sure | 4.3 | 2.9 | 5.1 | 6.7 | |||
| c. Ask you whether you think that your childhood experiences have affected your health? | Yes | 62.4 | 66.7 | 67.7 | 1.00 | 50.0 | 0.18 |
| No | 24.7 | 26.7 | 22.6 | 25.0 | |||
| Not sure | 12.9 | 6.7 | 9.7 | 25.0 | |||
| d. Listen carefully to you? | Yes | 96.4 | 100 | 96.7 | 1.00 | 91.7 | 0.19 |
| No | 2.4 | 0.0 | 3.3 | 4.2 | |||
| Not sure | 1.2 | 0.0 | 0.0 | 4.2 | |||
| e. Provide education about how childhood experiences can impact health and parenting? | Yes | 54.1 | 50.0 | 67.7 | 0.35 | 41.7 | 0.19b |
| No | 30.6 | 40.0 | 22.6 | 29.2 | |||
| Not sure | 15.3 | 10.0 | 9.7 | 29.2 | |||
| f. Provide you with referrals/resources that help people heal from childhood experiences? | Yes | 63.6 | 58.6 | 70.0 | 0.36b | 62.5 | 0.77b |
| No | 36.1 | 41.4 | 30.0 | 37.5 | |||
| 4. How comfortable was it for you to talk about these childhood experiences with your clinician? | Very comfortable | 59.5 | 73.3 | 73.3 | 1.00 | 25.0 | <0.001 |
| Somewhat comfortable | 33.3 | 26.7 | 23.3 | 54.2 | |||
| Somewhat uncomfortable | 6.0 | 0.0 | 3.3 | 16.7 | |||
| Very uncomfortable | 1.2 | 0.0 | 0.0 | 4.2 | |||
| 5. Did the conversation with your clinician about your childhood experiences: | |||||||
| a. Change your relationship with your clinician? | Yes | 10.6 | 6.7 | 12.9 | 0.67 | 12.5 | 0.65 |
| No | 89.4 | 93.3 | 87.1 | 87.5 | |||
| b. Increase your trust in your clinician? | Yes | 53.0 | 50.0 | 58.1 | 0.43b | 50.0 | 1.00b |
| No | 47.0 | 50.0 | 41.9 | 50.0 | |||
| c. Make you feel like your clinician knows you better? | Yes | 74.7 | 66.7 | 80.7 | 0.21b | 77.3 | 0.40b |
| No | 25.3 | 33.3 | 19.4 | 22.7 | |||
| d. Have a negative impact on your relationship with your clinician? | Yes | 4.7 | 0.0 | 6.5 | 0.49 | 8.3 | 0.19 |
| No | 95.4 | 100.0 | 93.6 | 91.7 | |||
| 6. Before your most recent prenatal visit, had you ever been asked by a healthcare professional about things that happened to you as a child, such as divorce, abuse, domestic violence, or mental illness? | Yes | 29.2 | 25.5 | 41.8 | 0.05 | 22.2 | 0.89 |
| No | 70.8 | 74.5 | 58.2 | 77.8 | |||
| 7. How much do you agree or disagree with the following statement?: | |||||||
| a. “Clinicians taking care of prenatal patients should ask their patients about things that might have happened to them when they were children” | Strongly agree | 50.5 | 45.6 | 60.3 | 0.26 | 48.9 | 0.61 |
| Somewhat agree | 34.5 | 36.9 | 27.6 | 37.8 | |||
| Not sure | 9.2 | 11.7 | 6.9 | 6.7 | |||
| Somewhat disagree | 4.4 | 2.9 | 5.2 | 6.7 | |||
| Strongly disagree | 1.5 | 2.9 | 0.0 | 0.0 | |||
| b. “Childhood experiences, such as abuse, exposure to domestic violence, and mental illness in a family member, can have long-lasting health consequences” | Strongly agree | 65.8 | 65.4 | 66.7 | 0.87 | 65.9 | 0.65 |
| Somewhat agree | 25.7 | 24.8 | 26.3 | 27.3 | |||
| Not sure | 3.5 | 4.0 | 5.3 | 0.0 | |||
| Somewhat disagree | 4.0 | 4.0 | 1.8 | 6.8 | |||
| Strongly disagree | 1.0 | 2.0 | 0.0 | 0.0 | |||
| 8. In general how satisfied are you with the efforts of Kaiser Permanente clinicians and staff, in responding to this issue? | Very satisfied | 49.3 | 52.0 | 53.5 | 0.36 | 37.8 | 0.16 |
| Satisfied | 32.2 | 31.4 | 31.0 | 35.6 | |||
| Not sure | 15.1 | 15.7 | 10.3 | 20.0 | |||
| Unsatisfied | 2.9 | 1.0 | 5.2 | 4.4 | |||
| Very unsatisfied | 0.5 | 0.0 | 0.0 | 2.2 | |||
| 9. Would you like info for yourself or a friend about resources for getting help in dealing with things you experienced as a child? | Yes | 10.8 | 2.0 | 17.2 | <0.001 | 22.7 | <0.001 |
| No | 88.2 | 97.0 | 82.8 | 75.0 | |||
| Not sure | 1.0 | 1.0 | 0.0 | 2.3 | |||
One hundred five patients had 0 ACEs, 59 patients had 1–2 ACEs, and 45 patients had 3+ ACEs. Questions 2 and 3a were only asked of patients who responded “yes” to question 1 (n = 198). Questions 3c–5d were only asked of patients who responded “yes” or “not sure” to question 3b (N = 85).
a
p-Values calculated using Fisher's exact test unless otherwise specified, boldface indicates statistical significance (p < 0.05).
b
Chi-square test.