Preventing Adverse Childhood Experiences: Data to Action (PACE:D2A)

Surveillance activities include:

• Adding questions about experiencing ACEs to the Connecticut Youth Risk Behavior Survey to provide representative state-wide estimates of ACEs for Connecticut public high school students.
• Bringing together ACEs-related data from across state agencies to better understand and characterize ACEs in Connecticut communities, including data from the Connecticut Departments of Children and Family Services; Education; and Mental Health and Addiction Services.

Prevention strategies and approaches:

• Ensure a strong start for children by providing training on ACE risk and protective factors to early childhood home visitation providers.
• Promote social norms that protect against violence and adversity through a public education campaign promoting safe, stable, nurturing relationships and environments for children and families.
• Strengthen economic supports to families by informing policies that strengthen household financial security and by increasing the number of families who claim the Earned Income Tax Credit.
• Teach skills by strengthening learning approaches that support the development of resilience.

Early Successes during first 2 years of program: Connecticut Launches Successful Public Awareness Campaign
A recent study found that a reduction in adverse childhood experiences (ACEs) could save Connecticut’s Medicaid program $1.1 to 1.9 billion between 2021 – 2030.¹ The Connecticut Office of Early Childhood, in partnership with the Connecticut Association for Human Services, is preventing ACEs by strengthening economic supports to families through their public awareness campaign on federal and state Earned Income Tax Credits (EITC).This campaign raises awareness of the connection between EITC, family stability, and child well-being.  The campaign released a series of social media posts in March 2021 on how to claim credits and access free tax support from the Volunteer Income Tax Assistance program.  This coming year, the campaign will grow to reach more households EITC income thresholds are expanded. EITCs can positively impact the financial stability of families and reduce parental stress, decreasing the risk of experiencing ACEs in childhood. The Connecticut Office of Early Childhood hopes that the public awareness campaign will increase uptake of EITC claims.

¹CHN Developed Dataset for CT Medicaid Population, projected to 2030.

Surveillance activities include:

• Adding questions about experiencing ACEs to the Georgia Youth Risk Behavior Survey to provide representative state-wide estimates of ACEs for Georgia public high school students.
• Utilizing data from the Georgia Student Health Survey to look at ACEs indicators, and risk and protective factors among youth in communities across Georgia.

Prevention strategies and approaches:

• Ensure a strong start for children by increasing access to early childhood home visitation programs.
• Promote social norms that protect against violence and adversity through public education campaigns to increase awareness of the 1-800-CHILDREN Helpline and promote parents seeking help.

Early Successes during first 2 years of program: Localizing Adverse Childhood Experiences (ACEs) Prevention in Georgia
Data from 2016-2018 show that 3 in 5 adults in Georgia have experienced at least one ACE.² To address this pervasive problem, Georgia’s Essentials for Childhood coalition, in partnership with state and local government leaders, providers of human services, educators, civic and business leaders, parents, caregivers, and members of faith-based organizations, created a plan entitled “A Vision for Child & Family Well-Being in Georgia.” This child abuse and neglect prevention plan outlines a collective approach to provide comprehensive services that strengthen and support families in Georgia. The plan focuses on addressing economic stability, family resiliency, early childhood education, mental and physical health, and community knowledge and awareness of the societal factors that contribute to child abuse and neglect. The Georgia Department of Public Health is building upon this plan by implementing specific ACE prevention strategies within 14 Division of Family and Children Services regions throughout the state. The Georgia Department of Public Health will use ACE data to increase implementation of early childhood home visitation and other evidence-based ACE prevention programs in identified under-resourced regions and communities.

² Davis, V.N., Bayakly, A.R., Chosewood, D., Drenzek, C. (2018). Data Summary: Adverse Childhood Experiences. Georgia Department of Public Health, Epidemiology Section, Chronic Disease, Healthy Behaviors, and Injury Epidemiology. https://abuse.publichealth.gsu.edu/files/2020/08/ACEs-one-pager-essentials-final.pdf.

Surveillance activities include:

• Adding questions about experiencing ACEs to the Massachusetts Youth Risk Behavior Survey to provide representative state-wide estimates of ACEs for Massachusetts public high school students.
• Using emergency department syndromic surveillance data to monitor certain ACEs in real time to help inform community needs and prevention efforts.

Prevention strategies and approaches:

• Promote social norms that protect against violence and adversity by engaging men and boys in Latinx communities as allies in prevention.
• Strengthen economic supports to families by informing policies that increase access to paid family and medical leave.
• Connect youth to caring adults and activities through mentoring and after-school programs and educate youth-serving providers on adverse and positive childhood experiences.

Early Successes during first 2 years of program: Prioritizing Positive Childhood Experiences in Massachusetts
Adverse childhood experiences (ACEs) can contribute to negative lifelong health and social consequences. However, positive childhood experiences (PCEs) also profoundly affect health and development, potentially preventing or buffering against toxic stress created by adverse experiences. The Massachusetts Department of Public Health recognizes the important role that PCEs play in creating an environment for healthy development and potentially mitigating the effects of adverse experiences. In 2021, the Massachusetts Department of Public Health included PCE questions in the Massachusetts Youth Health Survey. Including PCE questions will provide insights into how ACEs and PCEs are impacting communities across Massachusetts. The data will also help to direct (or allocate) ACE prevention resources to enhance safe, stable, nurturing relationships, and environments for children. In addition, understanding PCEs in youth may give insight into how paid family and medical leave improves caregivers’ ability to meet children’s basic needs and potentially create positive experiences for children. The Massachusetts Department of Public Health PACE: D2A program plans to utilize the survey data to inform PCE programmatic activities, including a training series for youth service providers, early childhood educators, and home visitors. The training will focus on increasing awareness and understanding of PCEs and how they buffer against the impact of trauma.

Surveillance activities include:

• Adding questions about experiencing ACEs to the Michigan Youth Risk Behavior Survey to provide representative state-wide estimates of ACEs for Michigan public high school students.
• Using data from Kids Count and the U.S. Census Bureau American Community Survey to better understand risk and protective factors across the social ecological model for ACEs in Michigan.

Prevention strategies and approaches:

• Promote social norms that protect against violence and adversity through a public education campaign to raise community awareness of ACEs and how to prevent them.
• Ensure a strong start for children through early childhood home visitation by integrating ACE prevention into the Michigan Home Visiting Initiative’s care plan.

Early Successes during first 2 years of program: Strong Partnerships Create New Opportunities for Michigan
Due to many barriers, adverse childhood experiences (ACEs) data collection among youth in Michigan has been limited. ACE data help identify populations with the highest need to tailor ACEs prevention strategies. Therefore, the Michigan Public Health Institute built a strong partnership with the Michigan Department of Education and the Michigan Department of Health and Human Services to incorporate ACE questions into the 2021 Youth Risk Behavior Surveillance System and Michigan Profile for Health Youth survey. These surveys provide both state- and community-level data, respectively.  The addition of ACE questions to these youth surveys will provide insight into how ACEs impact Michigan communities. The data will be used to allocate community prevention resources and monitor the impact of prevention interventions.

Surveillance activities include: 

• Continuing to include ACEs information on the 2022 Minnesota Student Survey to provide state and local ACEs estimates for Minnesota students in grades 5, 8, 9, and 11.
• Partnering with Minn-LInK, a research project investigating the effects of policies, practices, and programs on Minnesota families, to combine county and city data from multiple sources, including Child Protective Services, the Minnesota Department of Education, and the Minnesota Department of Human Services. These data will be used to develop indexes to understand how social determinants of health impact ACEs and associated risk and protective factors in each county.

Prevention strategies and approaches: 

• Partner with Minnesota Indian Women’s Sexual Assault Coalition (MIWSAC) to develop and implement an intervention to teach Indigenous boys and young men nonviolent conflict resolution skills, de-escalation skills, and communication strategies, which promotes social norms that protect against violence and adversity.
• Ensure a strong start for children by increasing access to home visitation and high-quality childcare for incarcerated families. Activities include trainings for Department of Corrections staff about:
  • ACEs
  • How providing services to parents and children simultaneously can help prevent ACEs
  • Best practices for supporting incarcerated parents, such as connecting them with social services via the online Help Me Connect tool

Surveillance activities include: 

• Adding questions about experiencing ACEs to the 2023 New Jersey Youth Risk Behavior Survey to provide representative, statewide ACEs estimates for New Jersey public high school students.
• Analyzing clinical health data integrated with social determinants of health data from multiple New Jersey communities. Analysis results will increase understanding of where families are experiencing high ACEs burdens to inform statewide policy and program planning by the New Jersey ACEs Interagency Team.

Prevention strategies and approaches: 

• Ensure a strong start for children through training development and delivery, including online ACEs risk and protective factor training for early home visitation providers and positive discipline training (about how to instruct and direct children by clearly communicating acceptable behaviors in a firm, gentle manner) for faith-based communities, schools, and other community groups.
• Promote positive social norms that prevent violence and adversity through public education campaigns that increase access to Connections Matter and positive discipline training.