{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:18:57Z","timestamp":1789449537604,"version":"build-2803163510"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T00:00:00Z","timestamp":1553731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to determine the prevalence of adverse childhood experiences (ACEs) in persons with inflammatory bowel disease (IBD) and whether having ACEs was associated with health care utilization post-IBD diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>Three hundred forty-five participants from the population-based Manitoba IBD Cohort Study self-reported ACEs (ie, physical abuse, sexual abuse, death of a very close friend or family member, severe illness or injury, upheaval between parents, and any other experience thought to significantly impacts one\u2019s life or personality) at a median of 5.3 years following IBD diagnosis. Cohort study data were linked to administrative health databases that captured use of hospitals, physician visits, and prescription drugs; use was classified as IBD-related and non-IBD-related. Mean annual estimates of health care use were produced for the 60-month period following the ACE report. Generalized linear models (GLMs) with generalized estimating equations (GEEs) with and without covariate adjustment were fit to the data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of at least 1 ACE was 74.2%. There was no statistically significant association between having experienced an ACE and health care use. However, unadjusted mean annual non-IBD-related general practitioner visits were significantly higher for participants exposed to physical and sexual abuse than those not exposed. Selected adjusted rates of IBD-related health care use were lower for participants who reported exposure to an upheaval between parents and high perceived trauma from ACEs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The estimated prevalence of at least 1 self-reported ACE in persons with diagnosed IBD was high. Health care use among those who experienced ACEs may reflect the impacts of ACE on health care anxiety.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izz054","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T07:30:36Z","timestamp":1553758236000},"page":"1700-1710","source":"Crossref","is-referenced-by-count":23,"title":["The Relationship Between Adverse Childhood Experiences and Health Care Use in the Manitoba IBD Cohort Study"],"prefix":"10.1093","volume":"25","author":[{"given":"Kelcie M","family":"Witges","sequence":"first","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8041-3574","authenticated-orcid":false,"given":"Charles N","family":"Bernstein","sequence":"additional","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"},{"name":"Departments of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn A","family":"Sexton","sequence":"additional","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"},{"name":"Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracie","family":"Afifi","sequence":"additional","affiliation":[{"name":"Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John R","family":"Walker","sequence":"additional","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"},{"name":"Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoann","family":"Nugent","sequence":"additional","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M","family":"Lix","sequence":"additional","affiliation":[{"name":"University of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"},{"name":"Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"2019091808542128300_CIT0001","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.amepre.2010.03.015","article-title":"Building a framework for global surveillance of the public health implications of adverse childhood experiences","volume":"39","author":"Anda","year":"2010","journal-title":"Am J Prev Med."},{"key":"2019091808542128300_CIT0002","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. 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