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njcmindia.com

national journal of community medicine is a peer-reviewed open access journal. it has a wide circulation amongst the health professionals, researchers, teaching faculties and postgraduates of the specialty of community medicine. the main objective of the journal is to promote wider distribution of the research conducted by researchers in the field of public health and community medicine.

popcouncil.org

Population Council – Ideas. Evidence. Impact.

pubmed.ncbi.nlm.nih.gov

Gates Foundation, St Jude Children's Research Hospital.

sciencedirect.com

sciencedirect is the world's leading source for scientific, technical, and medical research. explore journals, books and articles.

jabfm.org

Background: In 2020, the state of California started financially incentivizing primary care practices to screen for adverse childhood events (ACEs). In its current Medicaid 1115 waiver, the state also has encouraged health care teams to screen for social risks (SR) − (eg, food, housing, and transportation insecurity). In this qualitative study, we explore community health center (CHC) staff and patient perspectives about opportunities and barriers to integrating adult screening for ACEs and SR. Methods: We identified eligible California CHCs through Medicaid claims data on ACEs screening and/or participation in ACEs or SR-related learning collaboratives. Staff and/or patients in 12 clinics participated in semistructured interviews exploring opportunities and barriers to integrated ACEs and SR screening. Interviews were analyzed using a rapid qualitative data analysis approach. Results: Thirty-nine clinic staff (including clinic leaders, allied health professionals, licensed clinicians) and 10 patients participated. While staff and patients often conceptually endorsed integrated ACEs and SR screening, they identified substantial practical barriers to integration. Barriers primarily related to different screening frequencies and workflows. Other barriers reflected broader primary care time constraints and workforce shortages. Participants shared multiple recommendations to improve screening programs, including strategies for combining ACEs and SR screening. Discussion: California CHC staff and patients described several conceptual benefits of integrating ACEs and SR screening, but longstanding primary care challenges make it complicated to integrate these activities. Standardizing the integration of ACEs and SR screening will require institutional and structural shifts to overcome common barriers to providing whole person care.