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Hello,

Our health system is looking to pilot the ACE questionnaire in an adult primary care clinic and one of our OB clinics. I am looking for practices where the ACE has already been implemented in these types of adult clinics.  I have been doing my own research but have found it very difficult to find anything other than research studies that have been conducted in such settings. If anyone has contacts on adult clinics that have implemented the ACE I would very much appreciate being put in touch.

 

Thanks,

Heather Smith

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Pediatrician [and state legislator] George Till, introduced Vt. HB 762 in the 2013 Vermont legislative session-requiring ALL Vt. healthcare providers to screen all patients, regardless of age, for ACEs. Some implementation 'challenges' apparently occurred, as only one of the reportedly eight parts, passed that session. Last I'd heard, the bill is still active in the most recent legislative session.

One article I recently encountered addressed the issue of Physicians who have their own ACEs history, and whether "clinical supervision", in a social work sense, might be necessary to effectively assist patients with ACEs, or whether 'high speed' resolution techniques such as EMDR (with the O'Hara/Paulsen EMDR Protocols), or "LFT" used by some "First Responders" (EMT's and Paramedics/Police/Fire-Fighters/Dispatchers), involving the Vagus Nerve, or resources like the trauma-informed programming at JRI in Boston (where psychiatrist Bessel van der Kolk [author of "The Body Keeps the Score:..."] works), might be necessary adjuncts. One "Somatic Experiencing" practitioner I know, in NH, works in a primary care clinic-I don't recall if its just an adult clinic, and he may be available for consult through the Somatic Experiencing network/website.

Canadian Primary Care Physician, Gabor Mate, M.D. has written and/or presented on some ACEs related concerns... as well as Vincent Felitti, M.D.-the Co-Primary Researcher during the ACE Study at Kaiser-Permanente...

If Donald Wells, [formerly?] of Mid-America Health Systems Agency, is still in the Kansas City, Mo. area, he may know of some useful info. He worked at our NH Health Systems Agency before going to Mid-America in Kansas City.

Last edited by Robert Olcott
Heather Saenz Smith posted:

Thank you both for the responses, I will see what I can find related to your suggestions. Very Helpful!

Please get back to us with the results of your search. With the prevalence so high in primary care, and the significance for both physical and mental illnesses so great, it's a vitally important development in these financially constrained times.

Leslie Lieberman posted:

Brigid McCaw Kaiser Permanente in CA has been piloting in OB/GYN clinics. . Access Community Health Centers in Madison WI has also been screening adults.  Message me for connections. Finally I believe that Jane Stevens has written about some clinics screening adults on ACEs Connection and ACEs TOO High

Yes, I'm glad you posted! I do know of other places, but for us Downunder (the Equator, Aus or NZ), contacting some of these has not been easy -- do you have email addresses, or "just" phone numbers?

Heather Saenz Smith posted:

Thank you both for the responses, I will see what I can find related to your suggestions. Very Helpful!

I see your profile is as "spot-on" to the question as possible, but I was wondering if you had come up with any specific questions, or how broadly you had considered the topic -- from outside the US perspective, maybe?

In Australia, they've got the Blue Knot Foundation, formerly called Adults Surviving Child Abuse, both counselling service provider, and public education body -- including providing educational videos for "primary care providers" -- in Australia / NZ / England, doctors called GPs -- general practitioners. In fact, its "CEO" / Director, Cathy Kezelman, herself is a GP (ckezelman@blueknot.org.au) so for some questions she might be good to ask. I think her phone number, should you wish to go that far, is available on that site, or message me.

The ACE screening tool was used on adults in a prison in Nairobi, and a journal article reported on it. I don't immediately recall if it was the US CDC/Kaiser ACE screening tool or the World Health Organization's "WHO ACEA International Questionaire"-which is reportedly available in over 100 Languages on the WHO website [lower right corner of their webpage, but I don't know if 'Kiwi' is one of the 'languages']. If you're also planning to query their Resilience score too, I saw the Devereaux  (not sure if this is spelled correctly) Resilience Score tool some-where, as well.

Leslie Lieberman posted:

Brigid McCaw Kaiser Permanente in CA has been piloting in OB/GYN clinics. . Access Community Health Centers in Madison WI has also been screening adults.  Message me for connections. Finally I believe that Jane Stevens has written about some clinics screening adults on ACEs Connection and ACEs TOO High

Before I left for my FMLA I did read a bit about Brigid McCaw but was never able to make contact. Are you able to put me in contact with her or a someone else on her staff that may be helpful?

 

Thanks Leslie

 

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