Perinatal interventions for parents with exposure to adverse childhood experiences: A narrative review of suitability for implementation in primary care.

Children of parents exposed to adverse childhood experiences (ACEs) face elevated risk of experiencing biopsychosocial challenges. Primary care screening for parental ACEs is increasing, and routine primary care touchpoints may reach parents with exposure to ACEs during the critical perinatal period. This review seeks to 1) evaluate existing perinatal interventions-including those not designed for primary care-for suitability for primary care implementation and 2) identify implementation factors missing from existing interventions that may enhance their implementation in primary care. The PubMed database was searched for articles in English reporting on randomized controlled trials of perinatal interventions among parents with exposure to ACEs. Fourteen articles detailing 14 unique interventions were included in the qualitative synthesis. Data were extracted on intervention characteristics identified by implementation research as relevant to primary care: evidence of benefit, applicability and relevance, complexity, clarity, practicality and utility, costs, and adaptability. Ten interventions were found to be effective for parents with greater exposure to ACEs; however, the variability within the interventions and relevant settings suggests nuanced decision-making is required to match interventions to settings. The current review offers primary care providers a framework for matching and adapting such interventions.