Experiences and Perspectives of Minoritised People on Routine Enquiry of Adverse Childhood Experiences

In recent years, several services have been considering routine enquiry of Adverse Childhood Experiences (ACEs). This is happening in a context where few Black and minoritised people have been included in ACEs research. The first section contains a scoping review that aimed to understand how research has been conducted in the area of routine enquiry of ACEs and identify any gaps in knowledge. This was done by describing the methods of research on routine enquiry of adverse childhood experiences (ACEs), briefly summarising the main findings of the research, and evaluating whether race and ethnicity has been considered in the research. Systematic searches of online research databases were conducted, searching for all relevant research on the topic of routine ACE enquiry. The data was extracted from relevant studies and presented in a descriptive manner. Twenty-nine studies on practitioner views, service user views and feasibility were identified. Most studies were quantitative, conducted in the US, and used a variety of ACE measurements. Both practitioners and service users generally found ACE enquiry acceptable. Several studies did not report any demographics, and only a handful of studies seemed to have considered the ethnicity of their participants in any depth. It was concluded that there were several gaps in knowledge, including most studies being set in the US, a lack of qualitative research and a lack of demographic information. The lack of racial and ethnic equity considerations in research limits generalisability and transferability of research on routine ACE enquiry. Secondly, a research study was conducted to explore the experiences of Black people of being asked about ACEs, their perspectives on being asked about ACEs with a typical tool, and their perspectives on how services should be asking about ACEs. This study used a qualitative methodology, with a critical realist reflexive thematic analysis approach. Ten people who had been asked about ACEs previously were interviewed about their experiences and perspectives. The interviews suggested that participants found trust and safety to be key when being asked about ACEs, and that it was important that practitioners take the time to build a relationship before asking about ACEs. Participants found it important to be asked about ACEs, but reported several experiences of clinicians or services making it difficult to do so. Participants did not want to be asked about ACEs using a questionnaire.