Translating the Adverse Childhood Experiences (ACE) Study into Public Policy: Progress and Possibility in Washington State

On June 15, 2011, Washington became the first state in the United States to enact legislation aimed at preventing adverse childhood experiences (ACE), reducing their prevalence, and mitigating their effects. House Bill 1965 (HB 1965) was established on the understanding among legislators and Washington communities of the need for policies aimed at preventing child abuse, promoting healthy development of children, and building community capacity to improve public health. Empirical examples of integrating ACE-related research with public policy and programmatic design are chronicled. The legislators who developed HB 1965 lay out questions that, if answered, would further improve policymakers' ability to craft public policy and programs that prevent ACE, reduce their effects, and promote a healthier, safer future.     

Reducing Adverse Childhood Experiences (ACE) by Building Community Capacity: A Summary of Washington Family Policy Council Research Findings

Community capacity for organization and collaboration has been shown to be a powerful tool for improving the health and well-being of communities. Since 1994 the Washington State Family Policy Council has supported the development of community capacity in 42 community public health and safety networks. Community networks bring local communities together to restructure natural supports and local resources to meet the needs of families and children, and increase cross-system coordination and flexible funding streams to improve local services and policy. In this study, researchers sought to demonstrate the strong impact of the community networks' capacity to interrupt health and social problems. Findings suggest that community networks reduce health and safety problems for the entire community population. Further, community networks with high community capacity reduced adverse childhood experiences (ACE) in young adults ages 18-34.     

Adverse Childhood Experiences (ACE) Within a Social Disadvantage Framework: Distinguishing Unique, Cumulative, and Moderated Contributions to Adult Mental Health

The deleterious impact of adverse childhood experiences (ACE) may be confounded with frequently co-occurring social disadvantage. In this analysis we test the effects of ACE on adult mental health within a social disadvantage framework, using a population-based survey (n?=?7,444; mean age?=?55.2 years) from Washington State. We also examined the protective effects of socioemotional support, and the distinct and combined contribution of the measured ACE factors. Results demonstrated sustained impact of ACE on mental health many decades later, even net of social disadvantage and demographic contributors. Protective factors provided both direct and moderating influences, potentially masking the elevated effects of ACE for those with few resources. Toxicity examination of ACE items evinced differential effects of ACE experiences on mental health. These results demonstrate that interventions ameliorating the effects of ACE and bolstering protective resources such as socioemotional support may be effective toward augmenting mental health even late in life.     

Breaking Fresh Ground

ABSTRACT

In the present paper, the author introduces her roles and duties at her current job. The author then describes how she got into community psychology and primary prevention and how her graduate school and previous work experiences have influenced her current work. Focusing on primary prevention, the author delineates how the two community psychology concepts -primary prevention and action research -can be applied to the promotion of adolescent mental health in the Korean society. The author then adds advice for foreign students who are considering studying community psychology in the U.S.     

Sexual and intimacy health of Roman Catholic priests

This study explores the sexual experiences and sexual health of Roman Catholic priests. The qualitative research design looked at priests' responses to the question, "Please share one or more sexual experiences in your lifetime." The qualitative responses were analyzed and categorized into seven groupings: (a) Childhood and adolescent homosexual experiences; (b) Childhood and adolescent heterosexual experiences; (c) Both homosexual and heterosexual childhood and adolescent experiences; (d) Adult sexual experiences before ordination to the priesthood; (e) Adult sexual experiences since ordination to the priesthood; (f) Masturbation; and (g) Other sexual experiences. The data were analyzed by frequency of responses and percentages within each of the seven categories. The results indicate the need for early intervention and education during seminary, ongoing education after ordination, and psychotherapy support for priests.     

Understanding Adverse Childhood Experiences (ACE) and Their Relationship to Adult Stress Among Male Survivors of Childhood Sexual Abuse

Men who were sexually abused during childhood represent a highly stigmatized, marginalized, and under-researched population at risk for a variety of problems across the lifespan. The purpose of the current study was to (a) describe characteristics of child sexual abuse (CSA) and adverse child experiences (ACE), and (b) examine the relationships among CSA characteristics, ACE, and stressors in adulthood. Using a cross-sectional design, the researcher collected data on 487 adult men through an anonymous, online survey. Bivariate analyses revealed that five CSA characteristics-age at first abuse (r?=?-.164), number of abusers (r?=?.231), use of physical force, penetration, and physical injury-were related to the number of ACE. Three CSA characteristics (use of physical force, penetration, and physical injury) and the number of ACE (r?=?.162) were positively related to the number of stressors in adulthood. Preliminary recommendations for prevention, intervention, and future research are provided.     

Reconstructing the “Monsters” and the “Failures”

SUMMARY

“Monsters” and “Failures” are becoming the words of choice by many teachers, parents, administrators, and other adults when describing children and their behaviors. Ascribing the label can be constricting to the child and does very little to promote solutions to situations. Adults working with children can develop ways to look past the behavior and see the child and the child's needs, and acquire expectations of children that are in line with their development. This article explores the notion that family therapists, specializing in systems theory and parent education, are professionals, who are suited to help parents and school personnel interact with children in constructive and meaningful ways that promote development and minimize negative labeling. Family therapists can help the parent/teacher/administrator view the interactions among the components of the child's support system as dynamically interacting with one another and the child, and thus, strengthen the school-parent-community triad. Therapists, working col-laboratively with early childhood developmental education professionals, can assist adults in aligning their assessment and expectations of children with developmental understandings, thereby modifying the behaviors on the part of the adults, and ultimately eliciting more appropriate responses on the part of the children. A family systems approach to the rearing and teaching of children allows adults to reinforce the constructive behaviors of the child in a supportive and positive manner, leading to the social and cognitive growth of the child. The case material offered in this article presents ways in which family therapists can collaborate with education professionals and families in fostering the strength of the family-school-community relationship, and ensuring situations that are more child-friendly and developmentally appropriate.     

The Design and Implementation of Early Childhood Intervention Programs: Informing Efforts to Address Risk and Promote Resilience

With the goal of narrowing disparities in children's school success, a growing number of innovative early childhood interventions have been launched. As these interventions begin to show evidence of enhancing children's development, it is important that we understand the design of these interventions and their implementation. This themed issue of the Journal of Prevention and Intervention in the Community includes four articles that each highlight a different early childhood intervention program, and a fifth article that provides a commentary on the main set of articles, from a community perspective. The first article focuses on children with autism spectrum disorders (ASD) and a program that sought to integrate children with ASD into public schools. The next two articles center on children from low-income families, with a focus on preschool classrooms. The last article discusses a program that aimed to foster young children's school readiness as well as families' readiness for children's transition to school.     

The role of community in facilitating service utilization

Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parent's decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the community's ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention.     

The Role of Community in Facilitating Service Utilization

SUMMARY

Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parent's decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the community's ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention.     

School Violence Prevention

Abstract

School violence has many faces and many casualties. In varying degrees it touches students, parents, educators and communities of every school world wide. At the local level, communities are seen as playing a significant role in violence prevention. Generally, community-based violence prevention approaches involve the assessment of local problems, identification of target issues, selection of a range of interventions, and the encouragement of collaboration among civic groups, the juvenile justice system, local leaders, and young people themselves. These programs are generally judged as successful if they are able to address risk factors effectively for individual youths, strengthen those factors that provide protection and enhance resiliency, provide sufficient support and effective supervision, and increase pro-social attitudes by providing youth with a sense of having an increased stake in their local communities. Although too few educators are aware of its impact, the women's community has been involved in this work for decades. In this paper I discuss the results of interviews with members of the women's community in Atlantic Canada who have developed proactive violence prevention initiatives. I will concentrate on their efforts to bring those programs into the schools and their experiences of the successes and challenges they encounter.     

Parental attitudes following exposure to child abuse prevention campaign materials: a randomized trial

The purpose of this study was to evaluate child abuse prevention campaign materials. Using a randomized posttest design, 600 parents from an online research panel were recruited and surveyed. Multiple regression results indicate that exposure to the campaign materials had a significant relationship with four of the five domains (effects of child maltreatment, the appropriateness of harsh parenting, the physical dangers and needs unique to childhood, and the power to prevent child maltreatment). These results have implications for the child abuse prevention practitioners who seek to design and distribute effective campaign materials.     

Design and Implementation of Parent Programs for a Community-Wide Adolescent Alcohol Use Prevention Program

SUMMARY

Project Northland is a comprehensive community trial designed to evaluate programs for the primary prevention of alcohol-related problems during adolescence. It uses a community-wide model, that includes both demand and supply reduction techniques. The first phase of Project Northland (grades 6-8) was completed with the effective implementation of multiple, complementary programs including a multi-year social behavioral curriculum, intensive parental involvement components, peer leadership opportunities, and community-level changes through the formation of local task forces. This article describes the process used for developing and implementing the comprehensive parent interventions used during the first phase of the research, highlighting the elements that led to the successful implementation of the programs with very high participation rates by parents, their young adolescents, teachers, and community members.     

Pathways to aggression and violence among African American adolescent males: the influence of normative beliefs, neighborhood, and depressive symptomatology

Youth violence continues to present a serious public health challenge in the United States, particularly so for African American adolescent males. The present study utilized a multilevel approach to predict aggression within a community sample of low-income, urban African American adolescent males (n?=?80). Participants' self-report data on normative beliefs about aggression, exposure to community violence, and depressive symptoms were used in multiple regression equations to predict (a) self-reported interpersonal aggression and (b) self-reported aggressive response style when angered. Results of this study indicate that all three of the independent variables contributed significantly to the prediction of interpersonal aggression and aggressive response style when angered. The findings are important for increasing our understanding of pathways to various types of youth aggression and guiding the development of evidence-based approaches to violence prevention among African American adolescent males.     

Mobilizing Resilience and Recovery in Response to Adverse Childhood Experiences (ACE): A Restorative Integral Support (RIS) Case Study

The Restorative Integral Support (RIS) model is a comprehensive, whole person approach to addressing adversity and trauma. The Adverse Childhood Experiences (ACE) Study conducted by the Centers for Disease Control (CDC) and Kaiser Permanente reveals a relationship between childhood trauma and adult health and social problems. The current empirical case study presents the Committee on the Shelterless (COTS), in Petaluma, CA, as an example of one social service agency employing RIS to break cycles of homelessness. By applying RIS, research-based programming is offered within a culture of recovery that mobilizes resilience through social affiliations. The authors recommend RIS model implementation and research in programs serving populations with ACE backgrounds.     

PROSPECTIVE RESEARCH WITH VULNERABLE CHILDREN AND THE RISKY ART OF PREVENTIVE INTERVENTION

The Vermont Vulnerable Child Development Project is presented as an example of community based preventive intervention research employing multiple control groups and prospective epidemiology. Discussion emphasizes both methodological issues and the pragmatics involved in choosing to use community institutions in order to study preventive interventions for very young multi-risk children living with their mentally disturbed parents. Further, a rationale is provided for anticipating and coping with the political, sociological and personality conflicts which are probably inescapable in this type of mental health research.     

Stopping the Cycle of Child Abuse and Neglect: A Call to Action to Focus on Pregnant and Parenting Youth in and Aging Out of the Foster Care System

Each year, a significant number of adolescents become pregnant in the United States, with more than half of these pregnancies resulting in live births. Adolescent parenting is associated with poor outcomes, including increased risk of child maltreatment. Youth “aging out” of the foster care system may be at greater risk of maltreating their children due to their experiences of child maltreatment, a lack of social support, and little preparation for parenthood. This article examines current programs and policies targeting pregnant and parenting youth aging out and presents a research agenda that focuses on pregnancy prevention and positive parenting.     

The Relationship Between Child Maltreatment,Intimate Partner Violence Exposure,and Academic Performance

This article presents a longitudinal examination of the association between children's experiences of child maltreatment (CM) and intimate partner violence (IPV), alone and in combination, with children's academic performance. Integrated, administrative data from the Minnesota Departments of Education and Human Services were used to obtain a sample of 2,914 children. Data provided an opportunity to study comparisons of single (CM or IPV) and combined experiences (CM-IPV), longitudinally observe the impact of these experiences on academic functioning, and make comparisons to the general population. Results revealed significant differences in school attendance and math and reading performance by adverse experience. Children exposed to CM and IPV, individually or in combination, underperformed at school. IPV-exposed children had the poorest outcomes. Findings highlight the need for dedicated screening for adverse childhood experiences, particularly IPV exposure, and devoting greater educational and social service resources as a means of promoting future school achievement and adult functioning.     

Urban planning and mental health

Abstract

Both the product and the process of city planning have been shown to have an influence on mental health. This paper presents a model of the process through which community design characteristics influence mental health. The model emphasizes the importance of local social interaction and physical stimulation, as well as adjustment mechanisms used to dampen stress resulting from undesirable levels of interaction and stimulation. The research on the relationship between four community design characteristics and social interaction, stimulation and mental health is then reviewed. An argument for the importance of citizen participation is also presented, stressing the influence of participation on both sense of control and the development of social support. Commonly employed participation techniques, however, differ in their ability to affect support and control. Neighborhood council programs are identified as having the greatest potential for influencing sense of control and social support. Finally the obstacles to improving community design and specific recommendations for the prevention of environmentally induced mental health problems are presented.