What's missing? Violently injured Black men's narratives around Adverse Childhood Experiences (ACEs)

Background: Adverse childhood experiences have been associated with future outcomes; however, Felitti's 1998 ACEs questionnaire fails to capture the experiences of Black populations living in disinvested neighborhoods making it necessary to expand the ACEs questionnaire to examine the life experiences of violently injured Black men. Objective: The aim of the study was to advance the understanding of ACEs among Black male firearm violence survivors using the ACEs questionnaire and semi -structured interviews. Participants and setting: Ten Black male firearm violence survivors were recruited from an urban HVIP. Case managers conducted recruitment using the HVIP's REDcap database; active and previous HVIP participants were eligible for the study. Methods: A qualitative study design was used to understand the childhood experiences of Black male firearm violence survivors using Felitti's ACEs questionnaire and a semi -structured interview examining perceptions of their childhood experiences. Due to the COVID-19 pandemic, recruitment and interviews were conducted over the phone. Results: All participants experienced at least one ACE. Three themes arose from the interviews: youth incarceration, family separation and loss, and housing transition. Men at risk for violent injury experience ACEs beyond those measured in the current instrument.