Preventing and Mitigating the Effects of ACEs by Building Community Capacity and Resilience: APPI Cross-Site Evaluation Findings (Final Report)
Casey Family Programs
Empire Health Foundation
- Positive and statistically significant changes occurred in the areas of (1) building awareness of ACEs, (2) family support, (3) risk behavior reduction and healthy youth development, (4) school climate and student success, and (5) community development.
- Development of community capacity varied. It was highest in the areas of (1) cross-sector partnerships, (2) evidence-based problem solving, (3) shared goals, (4) effective communication with partners, and (5) focusing on equity. The networks had moderate capacity in (1) developing sustainable infrastructure; (2) engaging and mobilizing residents; (3) implementing trauma-informed programs, policies, and practices; and (4) increasing capacity to use data. All networks struggled to achieve communitywide change.
- Communities had multiple models of success. There may not exist one “best” community capacity building model. The networks that were more successful in addressing ACEs and building resilience aligned three factors: (1) collective community capacity, (2) community network structure, and (3) effective community change strategies.
- All networks face sustainability challenges. All networks had to independently find resources and support coalition infrastructure needed to sustain their work. Their staffs and budgets are small, and their grant-based funding is time-limited. The sustainability of these efforts depends on their ability to secure resources and implement a successful coalition leadership succession plan.
National leaders in health care, public health, and child development have identified adverse childhood experiences—or ACEs—as “the single greatest unaddressed public health threat facing our nation today.” Exposure to ACEs can have lasting negative effects on health and well-being, including impairing decision making, reducing impulse control, increasing adoption of risky behaviors, and contributing to early onset of disease, disability, and death. ACEs are common in the general population, with one in four adults reporting that they have experiences three or more ACEs. They are even more common among children living in nonparental care and those who have had contact with the child welfare system.
This mixed-methods evaluation examined the efforts of five local community networks in Washington State intended to prevent child maltreatment and exposure to toxic stress, mitigate their effects, and improve child and youth development outcomes. The findings are based on analyses of existing administrative and survey data using descriptive and quasi-experimental methods (such as pre-post, difference-in-difference, and interrupted time series methods) as well as analyses of study-administered ACEs and Resilience Collective Community Capacity (ARC3) survey of networks’ members and partners.
The development and testing of the ACEs and Resilience Collective Community Capacity Survey are described in Advancing the Measurement of Collective Community Capacity to Address Adverse Childhood Experiences and Resilience.