This blog post will describe a Multi-Level Public Health Resilience Building Intervention program focused on building resiliency in children and their caregivers who have experienced adverse childhood experiences (ACEs). The theme of the program is “Building Strong Kids and Families: The Power of Resiliency” and the name of the after-school program for the children is “Club Resilience.”
Adverse childhood events (ACEs) are traumatic events that occur before the age of 18 that significantly affect the child’s physical, mental and emotional well-being. Some examples of ACEs include physical, sexual and emotional abuse, neglect, and parental incarceration. ACEs are linked to chronic health problems, mental illness and substance use problems in adulthood and can also negatively impact education, job opportunities and earning potential in adulthood (Centers for Disease Control and Prevention (CDC), 2020; Felliti et al., 1998).
ACEs represent a preventable public health issue (CDC, 2019). The number and severity of ACEs can be reduced through prevention while intervention efforts can be used to mediate the long-term impact of ACEs on individuals and communities. There is a growing body of literature to support that building resiliency among children who have experienced ACEs can actually act as a protective factor against the negative long-term impacts of ACEs on individuals and communities (Bethel et al., 2017; CDC, 2021; Cohrdes & Mauz, 2020; Ortiz & Sibinga, 2017).
This after-school program will target elementary school aged children (ages 5-11 years old) enrolled at Riverside Central Elementary School in Rochester, Minnesota. This school was chosen as it has a socio-demographic profile that would suggest a higher prevalence of ACEs as approximately 70% of the students come from low income families (NCES, n.d.). The association between lower socioeconomic status and increased prevalence of ACEs has been established in the literature (Metzler, 2017; Walsh, 2019). Additionally, Riverside Central Elementary School has more racial and ethnic diversity than other schools in the Rochester Public School District with 64% of the students identifying with other than White/Caucasian (NCES, n.d.). This has important implications in being able to apply what is learned to broader populations.
The CDC’s four-level social ecological model (SEM) will be used as the framework to demonstrate the various levels where the program will have impact (CDC, 2022). This program aims to bring multilevel interventions to combat the effects of ACEs to the individual, relationship, community and societal levels. It has been well established that that multilevel interventions have the highest likelihood of being successful, especially when looking at reducing at risk behaviors (CDC, 2022).
The program will impact the all the various levels of the SEM model as follows:
Individual level: helping children develop their social emotional skills, coping skills, and problem solving skills through various activities that are known to enhance resiliency and protective factors.
Relationship level: the program provides children safe, stable nurturing relationships with adults and also provides an environment to foster positive peer relationships. The program also offers family engagement in various activities which are aimed to improve child-parent relationship.
Community level: this program engages the community by increasing the awareness of ACEs and what can be done to prevent and mitigate the negative outcomes of ACEs. The programming for both the children and adults are centered on strength based approaches versus deficit based methods. This helps to further engage the community to recognize their own strengths and resources to solve problems while also fostering community connectedness.
Societal level: there are plans in place to collect data on the outcomes the programs is impacting (academics, SEL outcomes, negative behavior in the classroom). This data will be used to lobby for increased funding for similar after-school programs in the City of Rochester and the State of Minnesota. Additionally, opportunities to increase adult programming and community education will be sought as ACEs and toxic stress tend to be intergenerational (Office of the California Surgeon General, n.d.). Breaking this cycle will ultimately result in improved health and well-being for society.
In summary, Building Strong Kids and Families: The Power of Resilience is a multi-level intervention that raises awareness of ACEs and offers prevention and treatment options for children and families who have experienced ACEs. Additionally, this program will help move the Rochester Public School District towards adopting a trauma informed approach in dealing with behavior issues, discipline polices, learning environments and staff-student, staff-parent interactions.
References
Bethell, C. D., Carle, A., Hudziak, J., Gombojav, N., Powers, K., Wade, R., & Braveman, P. (2017). Methods to assess adverse childhood experiences of children and families: toward approaches to promote child well-being in policy and practice. Academic Pediatrics, 17(7), S51–S69. https://doi.org/10.1016/j.acap.2017.04.161
Centers for Disease Control and Prevention. (2019, November 5). Adverse childhood experiences (ACEs) - vital signs. Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/aces/index.html
Centers for Disease Control and Prevention. (2020). Adverse childhood experiences (ACEs). Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/aces/
Centers for Disease Control and Prevention. (2021, January 5). Risk and protective factors. Centers for Disease Control and Prevention. https://www.cdc.gov/violencepr...otectivefactors.html
Centers for Disease Control and Prevention. (2022, January 18). The social-ecological model: a framework for prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/violencepr...ecologicalmodel.html
Cohrdes, C., & Mauz, E. (2020). Self-efficacy and emotional stability buffer negative effects of adverse childhood experiences on young adult health-related quality of life. Journal of Adolescent Health, 67(1). https://doi.org/10.1016/j.jadohealth.2020.01.005
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
Metzler, M., Merrick, M. T., Klevens, J., Ports, K. A., & Ford, D. C. (2017). Adverse childhood experiences and life opportunities: Shifting the narrative. Children and Youth Services Review, 72, 141–149. https://doi.org/10.1016/j.childyouth.2016.10.021
National Center for Education Statistics (NCES), U.S. Department of Education. (n.d.). Search for public schools - school detail for Riverside Central Elementary. NCES.ed.gov.https://nces.ed.gov/ccd/school...&ID=273180003077
Office of the California Surgeon General. (n.d.). ACEs and toxic stress | OSG. Retrieved February 28, 2022, from https://osg.ca.gov/aces-and-toxic-stress/
Ortiz, R., & Sibinga, E. (2017). The role of mindfulness in reducing the adverse effects of childhood stress and trauma. Children, 4(3), 16. https://doi.org/10.3390/children4030016
Walsh, D., McCartney, G., Smith, M., & Armour, G. (2019). Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review. Journal of Epidemiology and Community Health, 73(12), jech-2019-212738. https://doi.org/10.1136/jech-2019-212738
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