title: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Deployment Health Clinical Center (DHCC), Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Building 2, Room 3E01, Washington, DC 20307, USA.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Robinson
authors.forename: Jamie D
authors.initials: JD
authors.lastname: Davis
authors.forename: Mary
authors.initials: M
authors.lastname: Krueger
authors.forename: Kristie
authors.initials: K
authors.lastname: Gore
authors.forename: Michael C
authors.initials: MC
authors.lastname: Freed
authors.forename: Phoebe
authors.initials: P
authors.lastname: Kuesters
authors.forename: Shanta
authors.initials: S
authors.lastname: Dube
authors.forename: Charles C
authors.initials: CC
authors.lastname: Engel
mesh_terms: D054523:Adult Survivors of Child Abuse; D001290:Attitude; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D011159:Population Surveillance / Q000379:methods*; D011795:Surveys and Questionnaires