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PHC6534 Adverse Childhood Experiences and Criminal Justice System Involvement among Women in Alachua County, Florida: A Grant Proposal

Research has shown that individuals who experiences one or more adverse childhood experiences (ACEs) are more likely to have a range of psychosocial issues across their lifespan. It is imperative that public health professionals address this issue from a trauma-informed background. My grant proposal provides a recommendation for an evidence-based intervention that would target incarcerated women in Alachua county and a few surrounding areas. Below I go into more detail about what trauma-informed principles I utilized and how I incorporated the Social Ecological model.

The Trauma Informed Philanthropy Volume I discusses the concept of stages of prevention in the field of public health. The goal of primary prevention is to create conditions that would decrease the incidence and prevalence of negative health outcomes(Philanthropy Network Greater Philadelphia). This project will address the primary level of prevention by identifying and examining the social determinants of criminal misconduct among women. A portion of the task force will be primarily responsible for addressing these determinants. The second level of prevention is Secondary Screening. As explained in the Trauma Informed Philanthropy document, addressing the impact of ACEs will require a β€˜universal precautions’ approach to screening, meaning that professionals will have to assume that populations they are working with have a history of trauma. This project will address this stage of prevention by ensuring that all staff receive training on trauma-informedness as well as training on implicit bias. Finally, the third stage of prevention is Tertiary Treatment, which is focused on treating the health outcome to ensure better life quality. This project will address this level by connecting the incarcerated women with professionals that can help treat PTSD and other lingering issues from their past trauma.

The original social ecological model was created by Urie Bronfenbrenner in 1977 as a model for health promotion. The model includes four interrelated levels: individual, interpersonal, community, and societal. This program will focus primarily on the individual level of the social ecological model. The individual level is concerned with how individual level factors can influence behavior and vice versa. The knowledge, attitudes, and beliefs of a person are what determine their intention which is directly related to behavior. Additionally, the experiences of a person can also determine how they will behave. Since the target population of this program is currently or recently incarcerated women who have experienced one or more ACEs, it is important to try and understand what factors about these women led to their current predicament. Studying the individual level of the SEM will also allow me to predict how likely it is that the women will want to change their situation and remain out of the justice system. I chose to study this level particularly because my program will be working directly with the affected individuals as opposed to focusing on the interpersonal or community level factors surrounding this issue.Program activities will focus altering the knowledge and beliefs of the incarcerated women about ACEs, in hopes that they will feel able to make a change in their lives.

Additionally, I will be focusing on the policy level of the social ecological model. Women that are incarcerated need help to address and overcome the traumatic events that characterized their childhood, and it should be policy that these women are given the proper rehabilitation services while they are incarcerated. It will take key leaders in the community to recognize this issue and form a collaboration with local and federal governments to ensure these trauma victims are prioritized. This intervention will include a task force that will meet with these local leaders and government members in order to advocate for the incarcerated women and demand policy change. Once policies and laws have been put into place, prisons and correctional centers will have to integrate the new changes into their organizations.

The US Substance Abuse and Mental Health Services Administration (SAMHSA) has outlined 6 principles that should be integrated into any health promotion program. One of the trauma-informed principles that will be utilized is Safety. It is important for the safety of vulnerable populations to be prioritized. Incarcerated women constitute a specifically vulnerable population and because of this, one of my top goals with this program will be to ensure that the women are made to feel safe.This will include creating an environment in which they will feel comfortable expressing themselves confidentially. Unfortunately, some women return to unsafe and unstable situations after being released from the system and this increases the chances that she will continue to engage in criminal behavior. In order to avoid this, women in those situations will be provided with resources to help them find a safer situation to be in.

Trustworthiness and Transparency is another trauma-informed principle I will utilize. It is important that my program is used to build trust both among the incarcerated women and among lawmakers and others that can influence the creation of policies. Being open and transparent with the decisions and steps I take with this program will allow for others to evaluate the efficacy of the program. I believe having previously incarcerated women as working members is beneficial to the decision making process and they will be able to help me make decisions that are best for the community. Finally, I will incorporate the principle of peer support and mutual self-help. It is imperative that I listen first to the lived experiences of the women I am trying to help and then begin to make decisions on how best to move forward. It is also important for me to understand that some women will not want to share or relive their experiences and those women are just as important in the program. I think the concept of self-help is especially important here because the goal is to empower these women to confront their trauma and realize that they are capable of making the right decisions despite their pasts.

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