ArticleThe Permanente journal2026
Exploring the Association Between Adverse Childhood Experiences and Missed Primary Care Appointments in Adult Patients.
Article in The Permanente journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMissed medical appointments lead to adverse health outcomes and financial costs. Adverse childhood experiences (ACEs) are associated with poor health outcomes and may influence health care-seeking behavior in adulthood. This study explored the relationship between ACE scores and missed primary care appointments in a predominantly Black safety-net population.
methodsThe authors conducted a retrospective cohort study of 307 adult patients in a primary care clinic between January and August of 2022. Patients were recruited using a systematic sampling protocol and completed the 10-item Adverse Childhood Experiences Questionnaire. The primary outcome was no-show behavior, defined as having at least 1 scheduled appointment not attended and not canceled in advance. Logistic regression analyses assessed associations between ACE scores and missed appointments.
resultsThe sample was 91.9% Black, 44.0% male, with mean age 59.6 years. Average ACE score was 2.3, with 22.5% having ACE scores ≥ 4. Overall, 43.7% of patients had at least 1 no-show visit. ACE scores were not significantly associated with missed appointments (odds ratio, 1.01; 95% confidence interval, 0.89-1.14; DISCUSSION: Contrary to the authors' hypothesis, ACE scores were not associated with appointment adherence. Medicaid insurance status was the strongest predictor of no-show behavior, highlighting the impact of socioeconomic disadvantage on health care engagement.
conclusionSocial determinants such as insurance status may have a stronger influence on appointment adherence than childhood trauma history. Findings underscore the need to address structural barriers in vulnerable populations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.