TOP 24 - Understanding Pediatric Clinical Staff Perspectives on Adverse Childhood Experiences (ACEs) Screening, Trauma Screening, and Trauma-Informed Care (TIC) Implementation

Publication Number: 2776.TOP 24

Angela J. Shin, University of Colorado School of Medicine, Aurora, CO, United States; Kaitlin Whelan, University of Colorado School of Medicine, Aurora, CO, United States

Background: Adverse Childhood Experiences (ACEs) and trauma are linked to adverse physical and mental health outcomes. Trauma-informed care (TIC) frameworks promote safety, empowerment, and cultural humility. Despite efforts to promote these practices, routine screening and the integration of TIC are inconsistently adopted in pediatric settings. Additionally, there is limited research exploring the perspectives of multidisciplinary providers on screening procedures and TIC implementation.

Objective: To assess pediatric clinical staff familiarity, attitudes, and practices regarding ACEs and trauma screening and TIC integration, and to identify perceived barriers and facilitators within a large pediatric hospital system.

Design/Methods: IRB-exempt, cross-sectional survey of multidisciplinary pediatric clinicians at a tertiary children’s hospital. An anonymous 21-item REDCap instrument assessed demographics, familiarity with ACEs, trauma, and TIC, current screening behaviors, and perceived barriers and facilitators. Those surveyed included attending and resident physicians, nurses, advanced practice providers, medical students, psychologists, and allied health staff. Surveys were collected from September to October 2025. 185 participants initiated the survey and 151 completed it. Descriptive and comparative analyses by professional role and setting are ongoing. Categorical variables will be summarized as counts and percentages. Free-text responses will undergo inductive thematic analysis to identify recurring barriers and facilitators. Group differences by role and setting will be tested with chi-square or Fisher’s exact tests, and exploratory multivariable logistic regressions will be performed.
Preliminary analysis shows broad familiarity of ACEs, trauma, and TIC among pediatric staff but inconsistent screening practices and lower comfort responding to disclosures. Barriers center on time constraints, insufficient training, and workflow deficiencies. Frequently mentioned facilitators included structured education, adequate resources, and system-level supports.
This project provides a multidisciplinary evaluation of pediatric clinicians’ perspectives on ACEs and trauma screening and the implementation of TIC. Findings will inform the development of targeted, actionable training and bridge the gap between knowledge and practice by translating survey insights into a practical “TIC Toolkit.” Designed for applicability across general pediatric hospital and clinic settings, this project aims to strengthen clinician confidence and promote consistent, trauma-responsive care.

Table 1. Key Metrics from Preliminary Analysis of Pediatric Clinician Perspectives on ACEs, Trauma and TIC
TIC PAS TOP Table.pdfThis table summarizes descriptive statistics from a survey assessing familiarity, comfort, and screening practices related to Adverse Childhood Experiences (ACEs), trauma screening, and Trauma-Informed Care (TIC) among pediatric clinical staff. *Awareness and comfort scores were measured on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Percentages represent the proportion of respondents endorsing specific practices or identifying barriers and facilitators.