Adverse Childhood Experiences (ACEs): Development of an ACEs Knowledge Scale


BACKGROUND AND PURPOSE: Adverse childhood experiences (ACEs) negatively impacting children's health and later in their lives warrant necessity to educate nursing students about ACEs. The purposes of this study were to evaluate (a) nursing students' understanding of key concepts of ACEs using the ACEs Knowledge Scale (AKS) and (b) psychometric properties of the AKS. METHODS: A survey using AKS was conducted with randomly selected student participants ( = 344) to evaluate students' understanding of ACEs knowledge. Empirical validation of the AKS included content validity using Content Validity Index (CVI), reliability, and construct validity analyses. RESULTS: The results showed students in the Bachelor of Science in Nursing (BSN) program had increased knowledge of ACEs over pre-nursing students, and the BSN graduating students had increased knowledge related to trauma-informed care and building resilience. There were no significant differences in ACEs knowledge between Family Nurse Practitioner (FNP) and BSN students. Evaluation of psychometric properties of AKS revealed S-CVI/Ave=0.912, indicated excellent content validity based on the expert panel's ratings. Cronbach's alpha coefficient = .84 for the overall instrument indicated good reliability. Factor analyses were employed, showing that the 5-factor model gives good fit indexes, supporting the hypothesized factor structure of five key concepts. CONCLUSIONS: The AKS has showed promising implications to future research, nursing education, and nursing practice.

Publication Title

Journal of nursing measurement