The current state of patient-to-provider communication of childhood adversity in primary care

Kimberly A. Strauch, Jane M. Carrington, Thaddeus W.W. Pace

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Background:There is a wealth of literature focused on the task of adverse childhood experiences (ACEs) screening; however, little literature exists describing the broader process of ACE-related communication, specifically between nurse practitioners (NPs) and adult primary care patients. Consequently, there is no standardized process for communicating about ACEs in primary care and significant gaps remain related to how, when, and where these conversations occur.Objectives:To systematically examine peer-reviewed published literature from 2011 to 2021 to describe the current state of patient-to-provider communication about ACEs in primary care.Data sources:Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a focused literature search for the dates January 1, 2011 through January 1, 2021 using the search engines CINAHL, PubMed, Ovid, and PsycINFO with inclusion criteria of "adverse childhood experiences," "communication," and "primary care" provided boundaries for this systematic review.Conclusions:Findings revealed that effective communication about childhood adversity is an integral and understated element when addressing ACE exposure among adult primary care patients. Further research focused on how primary care NPs apply the concepts of effective communication while providing clinical care to adults with histories of childhood adversity is warranted.Implications for practice:This systematic review will serve as a catalyst for informing future research, theory development, and curricular initiatives focused on enhancing communication between primary care NPs and adult patients with histories of childhood adversity. From a clinical perspective, this will illuminate opportunities to develop NP-centered approaches that emphasize identification, interpretation, documentation, and development of individual, ACE-specific interventions among adults with ACE exposure in primary care.

Original languageEnglish (US)
Pages (from-to)649-655
Number of pages7
JournalJournal of the American Association of Nurse Practitioners
Issue number4
StatePublished - Apr 12 2022
Externally publishedYes


  • Adults
  • adverse childhood experiences
  • childhood adversity
  • communication
  • informatics
  • nurse practitioners
  • primary care

ASJC Scopus subject areas

  • General Nursing


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