Adverse childhood experiences (ACEs) are traumatic events that occur before the age of 18 that can have immediate and long-term negative health, behavioral, and social outcomes. Primary care providers (PCPs) can help mitigate the negative effects of ACEs by identifying at-risk children and families in need of support. This cross-sectional study, that incorporates inter-clinician variability into the sample, explored PCPs ACE knowledge, training, screening practices, and perceived intervention barriers to addressing ACEs. Results found that PCPs had limited familiarity with the ACE study and the effects of ACEs, few PCPs received training on ACEs, only some PCPs formally screened their patients for ACEs, and lack of time and training were PCPs most cited perceived barriers to addressing ACEs. A statistically significant difference in PCPs ACE knowledge and perceived barriers to addressing ACEs by inter-clinician variability was found. To more effectively address ACEs in the primary care setting, the following is recommended - effective ACEs educational tools and resources for both resident and attending PCPs, training on addressing sensitive topics including ACEs beginning in resident physician education, efficient models for ACEs office-based screening, increased access to mental health care for patients, strengthened care coordination with community organizations, and collaborative practice networks.

不良童年经历 (ACE) 是发生在 18 岁之前的创伤性事件，可能对健康、行为和社会造成直接和长期的负面影响。初级保健提供者 (PCP) 可以通过识别需要支持的高危儿童和家庭来帮助减轻 ACE 的负面影响。这项横断面研究将临床医生间的差异纳入样本，探讨了 PCP 的 ACE 知识、培训、筛查实践以及解决 ACE 的感知干预障碍。结果发现，PCP 对 ACE 研究和 ACE 的影响的了解有限，很少有 PCP 接受过 ACE 方面的培训，只有一些 PCP 正式筛查患者的 ACE，缺乏时间和培训是 PCP 最常提到的解决 ACE 的障碍。发现 PCP 的 ACE 知识和通过临床医生间差异解决 ACE 的感知障碍存在统计学上的显着差异。为了更有效地解决初级保健环境中的 ACE，建议采取以下措施 - 为住院医师和主治 PCP 提供有效的 ACE 教育工具和资源，解决敏感话题的培训，包括从住院医师教育开始的 ACE，有效的基于办公室的 ACE 筛查模型，增加患者获得精神卫生保健的机会，加强与社区组织和协作实践网络的护理协调。