A quality improvement (QI) study that integrates an adverse childhood experiences (ACEs) instrument, including the Quick Parenting Assessment (QPA), into pediatric primary care visit.

Adverse childhood experiences (ACEs) are social determinants of health. ACEs include exposure to unhealthy parenting and family dysfunction. It is known that people who are exposed to adverse childhood experiences (ACEs) are at increased risk of over 40 health problems; some of these include heart disease, lung disease, obesity, smoking, alcoholism, illicit drug use, depression, suicide, and violence. The American Academy of Pediatrics recommends that primary care providers screen for and address ACEs/social determinants of health as part of the routine primary care visit.

Efforts are needed to develop and test algorithms that assess for ACEs in pediatric primary care and intervene as indicated.

The investigators have tested an ACEs screening instrument that includes the Quick Parenting Assessment with hundreds of parents of 2-10 year old children in the pediatric primary care clinic at Vanderbilt without incident (please see IRB# 161987).

The next step is a quality improvement (QI) study that integrates an ACEs screening algorithm into pediatric primary care visit.

In this study, the investigators integrate the Quick Parenting Assessment into the pediatric primary care visit at the 15 month, 30 month, 5 year, and 8 year visit. Key measures include parents' and health care providers' perspectives on the new service.

Inclusion Criteria:

• Parents of 1-10 year old children presenting to a pediatric clinic for a well child visit.

Exclusion Criteria: Parents who do not speak English, Spanish, or Arabic.

Parents of young children presenting with their child for a well visit.