Marcia Stanton, MSW, coordinator of child abuse prevention at Phoenix Children’s Hospital shared her journey in implementing an ACE (Adverse Childhood Experience) program at her hospital to make a statewide impact on child abuse education, prevention and treatment.
Getting started
For Stanton, this journey started in 2006 when she read an article on "Relationship of ACE to Adult Health: Turning Gold Into Lead," (PDF) by Dr. V.J. Felitti. Stanton invited Felitti to Phoenix for a Pediatric Grand Rounds to speak to hospital staff and held a community leader luncheon with more than 100 attendees.
From the ACE Study website, "The ACE Study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. Led by Co-principal Investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, the ACE Study is perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life."
Developing direction
The community leader lunchen had produced some low level interest but not a lot of progress, so in 2007, Felitti was invited back to Phoenix for a more concentrated community round table, out of which came the ACE "think tank" to look at "what does this mean" and "what can we do about it?" The think tank met throughout 2008 and started to set goals and build partnerships.
In 2009, goals became clearer, looking at more evidence based data. and the hospital eventually reached out to the local PBS station as a longterm partner in support of the ACE initiative. The "think tank" model eventually developed into the more official ACE Consortium
In 2010, the hospital a free two day "train the trainers" event and developed a "Strong Kids" toolkit as collateral, with resources to help attendees share the ACE ideas. The training session was attended by about 40 people from regional child abuse prevention councils, and another 35 professionals; each promised to share what they learned with other groups. In the first few months after being trained, the 75 trainers had presented to diverse groups totally more than 15,000 people across the state. A second train the trainer event will be happening next week to train another 60 trainers.
PBS Success
Through the PBS partnership, the station offered its services to create and host a Strong Kids web page. It also collaborated to put on a primetime Horizon special about the ACE program and, later, a primetime "Ask the Trauma Expert" Q&A with four local experts. (Both specials can be viewed on the Strong Kids web page.) The pre-recorded Q&A was aired with live bank support staffed with volunteer local child abuse professionals who answered calls throughout the show. The special was well received and another special will be aired soon. The PBS partnership has also helped connect the hospital to other community partners.
Outcomes and next steps
The ACE Consortium meets quarterly with a large and varied membership, requires limited funds and reinforces Phoenix Children's Hospital as a statewide leader. So far, the education and outreach efforts have unified the child abuse prevention message nationwide. They have trained 75 trainers -- soon to be 135 -- and those trainers are educating tens of thousands of other people about ACE. The group is also helping facilitate the Arizona rollout of Triple P -- Positive Parenting Program, one of the best researched and substantiated programs at reducing incidence of child abuse.
Lessons learned
Stanton offers several lessons learned from her experience with introducing an ACE program:
- There is widespread interest in implementing child abuse prevention
- Complicated issues require collaboration, and synergy is found in working together
- A program doesn't require lots of money; the Strong Kids program spent $450 to develop a logo and tagline, $2500 on developing and printing Strong Kids toolkit and other collateral; $2500 on the PBS primetime Horizons special; and $8000 on the Ask a Child Trauma Expert primetime special.Most of their resource support is donations of time or in kind provisions rather than money, though they money has become available when needed. Stanton herself is part time, 100 percent grant funded.
- An organic approach worked for Phoenix Children's (but this may not work for everyone)
- To create a child abuse prevention initiative, you have to be in it for "the long haul;" at Phoenix Children's, it took approximately four years to really get started and bring the resources together to have a tangible effect and momentum for the future.
Resource links
Stanton suggest the following links to look to for more resources; these organizations provided the understanding, research and support that helped Phoenix Children's develop its program.
- Stanton's Creating Connections Conference slide presentation and handout
- ACE Study
- Frameworks Institute
- National Scientific Council on the Developing Child
- CDC Strategic Direction of "Promoting Safe, Stable and Nurturing Environments"
- Prevention Institute
- 99 Designs (inexpensive resource for logo design, branding, graphics, etc.)
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