Screening for Adverse Childhood Experiences (Aces) In Arab Countries: Exploring Measurement Tools and Physicians’ Perspectives

Abstract

Adverse Childhood Experiences (ACEs) are linked to negative health outcomes. This research examines tools used to assess ACEs in Arab countries and explores knowledge, attitudes, and practices of primary healthcare physicians in Qatar regarding ACEs screening. Two methodological approaches addressed the research aims. First, a scoping review conducted in October 2023 searched six databases for studies on ACEs assessment tools in the Arab world. Duplicate removal and two-stage screening (titles/abstracts then full-text) by independent reviewers ensured methodological rigor, aligning with JBI recommendations. Second, a cross-sectional survey assessed knowledge, attitudes, and practices regarding ACEs screening among Qatar’s primary healthcare physicians. Using Theoretical Domain Framework and STROBE guidelines to inform this survey, targeting family medicine and well-baby clinic physicians across PHCC health centers. Data analysis included descriptive statistics, construction of an attitude score, application of the Intraclass Correlation Coefficient (ICC) to account for clustering effects, and utilization of adjusted chi-square, univariate logistic regression, and univariate linear regression to explore knowledge predictors and relationships with attitudes. The scoping review identified a diverse range of tools, mostly researcher-developed and used for research, with limited validation and standardization. The physician survey (n=205) revealed low knowledge of ACEs screening tools (34.15% heard of an ACEs questionnaire). Despite this, attitudes towards screening were generally positive (mean score 37), favoring the context of universal screening across all ages. However, significant barriers were identified (time constraints, lack of training, patient relevance concerns). Despite these barriers, 59% of physicians reported asking about ACEs when indicated. Years of experience were associated with knowledge, while work setting and knowledge were linked to more positive attitudes. These findings highlight the need for standardized ACEs tools and comprehensive training for healthcare providers in the Arab world. It contributes to understanding current practices in Qatar and lays the groundwork for future research to improve identification and support mechanisms for individuals affected by ACEs.