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Adverse Childhood Experiences and Family-Centered Care

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Abstract

Adverse Childhood Experiences (ACEs) include experiences of child maltreatment and household dysfunction. Prior work has shown that children with ACEs may have suboptimal utilization of preventive health care, including annual well-visits, however little is known about the relationship between ACEs and quality of patient care. Using data from the 2020 National Survey of Children’s Health (N = 22,760) a series of logistic regression models estimated associations between ACEs, both individually and cumulatively, and five components of family-centered care. Most ACEs were consistently associated with lower odds of family-centered care (e.g. financial hardship was associated with doctors always spend enough time with children, AOR = 0.53; 95% CI = 0.47, 0.61), except for having a parent or guardian die, which was associated with higher odds. Cumulative ACE score was also associated with lower odds of family-centered care (e.g. doctors always listened carefully to the parent, AOR = 0.86; 95% CI = 0.81, 0.90). These findings emphasize the importance of the consideration of ACEs in the context of family-centered care, and support the need for ACEs screening in the clinical setting. Future work should focus on mechanisms explaining the observed associations.

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Data source is publicly-available.

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Funding

No funding received for the present study.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, USA

    Amanda E. Ng & Héctor E. Alcalá

  2. Department of Global Health, McMaster University , Hamilton, ON, L8S 4L8, Canada

    Zoha Salam

  3. New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, 11568, USA

    Nicholas Tkach

  4. Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, 21201, USA

    Héctor E. Alcalá

  5. Program in Oncology, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, 21201, USA

    Héctor E. Alcalá

Authors
  1. Amanda E. Ng
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  2. Zoha Salam
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  3. Nicholas Tkach
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  4. Héctor E. Alcalá
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Contributions

AE Ng contributed to the Introduction, Method, Results, and Discussion. Z Salam and N Tkach contributed to the Introduction. HE Alcalá completed the analysis, interpreted results, and contributed to the Methods, Results, Introduction and Discussion. All authors reviewed the results and approved the final version of the manuscript.

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Correspondence to Héctor E. Alcalá.

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Ng, A.E., Salam, Z., Tkach, N. et al. Adverse Childhood Experiences and Family-Centered Care. J of Prevention 44, 561–578 (2023). https://doi.org/10.1007/s10935-023-00738-y

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