Adverse childhood experiences (ACEs) are associated with a number of negative physical, mental, and behavioral health outcomes throughout the lifespan, and are unfortunately very common. Children and families in Hialeah, Florida, a Cuban immigrant community in Miami-Dade County, are at a heightened risk of experiences ACEs due to widespread poverty and linguistic isolation. The proposed program is an attempt to address the needs of this community, reduce the prevalence of ACEs, and ultimately improve health outcomes through a home-visiting program and the development of social support networks. Eligible families with children ages five and under will receive monthly home visits from specialists to help parents and caregivers cope with past trauma and provide developmental and educational services for children. Ultimately, the program aims to provide families with strategies, resources, and social support to mitigate the impacts of trauma in the community.
Public Health Framework: The proposed program would address trauma at the three levels of prevention. Primary prevention of childhood trauma will be applied by taking a systems-level approach and striving to make the community healthier and safer. This will be accomplished by providing parents with appropriate trainings to educate them about ACEs and promote resilience and connecting them with relevant social services to promote positive parenting and help alleviate poverty. Further, screening at-risk children for ACEs during home visits and selecting program participants from an at-risk population are components of secondary prevention. Finally, working with parents to help them process past trauma is a tertiary prevention strategy, as is working with children who have already experienced trauma.
Trauma-informed principles: The principles utilized by this intervention are safety, peer support and mutual self-help, empowerment, voice, and choice, trustworthiness and transparency, collaboration and mutuality, and cultural, historical, and gender issues. Emphasis would be placed on the creation of peer support networks, addressing relevant cultural barriers, involving community members, creating a safe space for collaboration and for participants to share their experiences, and always being transparent about the program's goals.
Levels of the social-ecological model: The program would operate at the individual, interpersonal, and community levels. The home visits would focus on the interpersonal level, working to develop relationships between the families and specialists and strengthen family systems. The individual level is at play because the specialists would teach families relevant strategies and tool and inform them about the prevalence and impact of ACEs. At the community level, community members would be involved in implementing, developing, and evaluating the program, and the development of peer support networks would be facilitated.
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