2025-05-06-兰德-加州大学洛杉矶分校-加州大学旧金山分校ACE意识家庭复原力网络（UCAN）的早期影响评估（英）-85页_85页_6mb

Summary

The UCLA/UCSF ACEs Aware Family Resilience Network (UCAAN) evaluation found that its Becoming ACEs Aware (BAA) training program has significantly increased clinical capacity to screen for Adverse Childhood Experiences (ACEs) among Medi-Cal providers. Over 44,000 individuals, primarily physicians and nurses, completed the training, with high satisfaction ratings (93-99%) and strong evidence of lasting impact.

Key findings:

• 90% of surveyed BAA-trained clinicians reported increased knowledge of Trauma-Informed Health Care (TIHC), 85.7% paid more attention to patients' ACEs, and 90% currently screened some patients.
• Sustained impact was reported for BAA and supplemental trainings, with lingering barriers ("insufficient training") seen 6-12 months later.
• Adult ACE screening rates (6.3%) lagged substantially behind child rates (31.0%), highlighting implementation challenges.
• The evaluation demonstrated UCAAN's foundational role but acknowledged limitations in rigorously assessing health outcomes beyond screening, defining "implementation," and directly evaluating systemic changes, which require longer timeframes (decades).

Major Findings

Implementation growth:

• Steady BAA training uptake (approx 400/month).
  Provider experiences:
• High training satisfaction and clinical impact evidenced across diverse professional roles.
  Screening practices:
• BAA correlated with high ACE screening rates (~16.5% statewide beneficiaries 2020-2024).
  System-level challenges:
• Significant regional disparities ("Medi-Cal clinicians trained per 1,000 beneficiaries" varied widely).
• Adult screening rates remain substantially lower than pediatric rates.
  Systemic impact limitations:
• UCAAN influenced provider/patient relationships, system collaborations, and TIHC model development.
• Challenges sustaining screening practices and connecting results to referrals persist.

Recommendation Schema

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1. **Expand coverage**

    - Focus outreach on unscreened regions: Inland Empire, Southern SJV
    - Diversify trainings to non-clinical staff

2. **Optimize adult screening rates**

    - Develop tailored implementation guidance for adult-serving clinics
    - Collect/analyze adult-specific screening data

3. **Enhance implementation support**

    - Translate pilot project findings into standardized clinic tools
    - Develop system to translate UCAAN research into actionable implementation guidance

4. **Improve TA efficiency & reach**

    - Standardize responses to recurring T/As
    - Increase visibility among non-traditional ACE audiences

5. **Secure advanced reimbursement policies**

    - Support ongoing claims support
    - Advocate for broader sustainable funding mechanisms for intensive follow-up