Acceptability of adverse childhood experiences questions for health surveillance in U.S. armed forces

Abstract

Background: Research has documented a consistent and strong association between adverse childhood experiences (ACE) and negative health outcomes in adulthood. The Department of Defense is expanding health surveillance of military members and considering the inclusion of ACE questions. Objective: To explore the perceptions and attitudes of service members and spouses regarding the use of ACE questions in routine health surveillance. Method: Forty-one active duty service members and spouses were interviewed at two Army troop medical centers. Semistructured qualitative interviews were used to examine their views regarding the use of ACE questions in military health surveillance. Results: Participants believe there is value in health surveillance; however, they are cautious about providing ACE or other information that may be perceived negatively, without confidentiality reassurances. Conclusion: Successful employment of ACE questions in active duty military health surveillance will depend on the ability of military health officials to ensure confidentiality and to communicate the relevance of ACE to health status.