Transcript Slide 1

Opportunities for Early
Childhood Systems Building
Using the ACEs Study:
Iowa’s Experience (so far)
ACE Study Provides a Paradigm Shift on
Addictions & Unhealthy Behaviors
Adverse Childhood Experiences (ACE) Study
• Decade long study involving 17,000 people.
• Examines the health and social effects of ACEs
throughout the lifespan.
• Largest study ever done on this subject.
• General Findings: Childhood experiences are
powerful determinants of who we become as
adults.
Dr. Vincent Felitti
Dr. Rob Anda
ACEs Questionnaire
 Physical abuse
 Emotional abuse
 Sexual abuse
 An alcohol and/or drug abuser in the
household
 An incarcerated household member
 Someone who is chronically depressed,
mentally ill, institutionalized, or suicidal
 Mother is treated violently
 One or no parents
 Emotional or physical neglect
Adverse Childhood Experiences are Common
Of the 17,000 HMO Members ~
Household Dysfunction:
Substance abuse
Parental sep/divorce
Mental illness
Battered mother
Criminal behavior
Abuse:
Psychological
Physical
Sexual
Neglect:
Emotional
Physical
27%
23%
17%
13%
6%
11%
28%
21%
15%
10%
Population
Average
Most frequently asked question in Iowa
after learning about the ACEs
study is:
“Now what?”
Central Iowa’s Process
Established Central Iowa ACEs Steering
Committee
Started with “a small group of thoughtful,
committed citizens…” inspired by the ACEs
study with an understanding that there is a
responsibility that comes with now knowing
this information.
Top 5 Game Changers
to Getting Traction in Iowa
1) Created the Central Iowa ACEs Steering Committee
2) Developed public/private co-investment partnership to
fund ACEs module in state BRFSS
3) Statewide ACEs Summit
4) Created Iowa ACEs 360 Website
http://www.iowaaces360.org/
5) Developed a Visioning and Strategic Planning Timeline
Scope of ACEs Work
To enhance the individual and community capacity to
prevent and respond to adverse childhood experiences
and toxic traumas
To engage as many partners as possible across a variety
of disciplines, at both a state and local level about the
impact of ACEs
• Broad-based
• Recognize no cookie cutter approach to this work across
sectors and communities
• Focus on education & awareness
• Use current and continually evolving research to ground
policy and practice recommendations
States Collecting ACE Data
2009-2012
2012
2009-2012
19 States
No data
2009
2010
2011
Source: Behavioral Risk Factor Surveillance System, CDC.
Possible Policy & Practice
Implications
Improve effectiveness of public health campaigns by refining
messages grounded in ACEs findings
Integrate trauma-informed professional development across
state departments and family-serving systems
Increase policymaker understanding of the prevalence of ACEs
to inform policy decisions, such as Iowa’s Mental Health
Redesign, the Healthiest State Initiative, and Education
Reform efforts.
Promote early identification and intervention efforts through
universal screening and assessment within family-serving
systems.
• ACEs are common
• ACEs are interrelated
• ACEs are associated with:
– Mental Health Outcomes
– Health Risk Behaviors
– Physical Health Outcomes
– Socioeconomic Status
– Medicaid/Badger Care Enrollment
– Quality of Life
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• Increase public awareness of ACEs and their
impact on health and well-being
• Increase assessment of and response to
ACEs in health and other human service
settings
• Enhance the capacity of communities to
prevent and respond to ACEs
• Continue to collect Wisconsin-specific data
on the relationship between ACEs and health
outcomes
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Iowa ACEs Summit Participant Survey Results
1) Close to 90% of respondents found the ACEs study findings to be relevant
or very relevant to their field of work.
2) Respondents anticipate making changes in their field of work based on
what they learned from the summit.
• The most common plan was to educate colleagues and employees about ACEs.
Other responses included:
• Sharing what they learned at the summit with parents and clients they work with.
• Incorporating what they learned at the summit directly into their work with
children and clients
• Screening clients for ACEs
3) Participants see themselves getting involved in Iowa’s next steps
• Most respondents expressed an interest in spreading awareness about ACEs or
learning more themselves.
• Others would like to serve on committees or take other leadership roles. Many
were unaware of existing community initiatives working to infuse ACEs at the
time and would like to learn about opportunities to get involved as they come up.
Iowa ACEs Summit Participant Survey Results,
continued…
Recommended Key Stakeholders
•Department of Education
•Health Care Professionals (including mental health)
•Department of Public Health.
•Legislators
•Department of Human Services and social workers
•Non-profits and community action agencies
•Law enforcement and the justice system
•Businesses
•Faith-based organizations
•Parents
Iowa ACEs Summit Participant Survey Results,
continued…
Recommended Next Steps for Iowa ACEs Steering Committee
1) Close to one third of respondents indicated interest in
participating on the Central Iowa ACEs Steering Committee.
2) The Central Iowa ACEs Steering Committee can support local
and state planning efforts by:
• Educating the public and increase awareness around
ACEs in a variety of ways including conferences, meetings,
and trainings.
• Building connections and relationships throughout the
community.
• Developing models and frameworks
• Lobbying for policy change
• Providing resources to people affected by ACEs and the
agencies that serve them.
Challenges to Moving Ahead
1) No full time dedicated staff
2) Waiting for Iowa data when interest in high
3) Speaker capacity on ACEs (The more public speaking on
ACEs, the higher the demand for speakers across the state
to continue spreading the word)
4) Shift in how services can/should be delivered will require
multiple level strategies
5) Stay focused on strategic plan, and yet flexible enough to
incorporate innovations
6) Long term commitment to changing intergenerational
transmission of ACEs
Recommended Resources
Family Policy Council of Washington:
http://www.fpc.wa.gov/
Frameworks Institute:
http://www.frameworksinstitute.org/
Harvard Center on the Developing Child:
http://developingchild.harvard.edu/
Iowa ACEs 360:
http://www.iowaaces360.org/
National Child Traumatic Stress Network:
http://www.nctsn.org/
Wisconsin Children’s Trust Fund:
http://wichildrenstrustfund.org
Sonni Vierling
State Coordinator
1st Five Healthy Mental Development Initiative
Iowa Department of Public Health
[email protected]
(515) 281-8284