Hindsight can be very valuable, especially for members of the Central Iowa ACEs 360 Steering Committee. Four years after Dr. Robert Anda, one of the two principal investigators of the CDC-Kaiser Permanente ACE Study, introduced the research at a conference in early 2011, they can see clearly how much progress they’ve made. They’ve even labeled the progression: 2011 was the year when the research sparked action, beginning with forming the Central Iowa ACEs 360 Steering Committee. In 2012 and 2013, ACEs conversations began and awareness of ACEs grew in the state. In 2014, Iowa developed a response to ACEs, and in 2015, the ACEs movement leaders set a bold vision.
In the four years following that conference, the state has completed three ACE surveys and now plans on doing an ACE survey every year. The organization has hosted three ACEs summits; a statewide summit in 2014 focused on ACEs in early childhood, education and juvenile justice. More than a dozen organizations have or are integrating ACEs into their services. You can read the case study about their first three years here.
Over the last year, the steering committee’s most important accomplishment was to approve a strategic plan for 2015-2016 and a new coalition structure. The strategic plan follows the Spectrum of Prevention framework from the Prevention Institute. Gathering and producing data continues to provide the reason and impetus for the committee’s work.
The new coalition structure comprises three parts:
- Community Learning Circle – Anyone can join to be part of the ACEs movement in Central Iowa, and members will convene at least twice a year.
- Steering Committee – Members are invited. Currently, there are 31 people representing 21 organizations, either state-wide organizations or agencies, or organizations whose focus is on Central Iowa.
- ACEs Action Groups – The groups include the Iowa ACEs Advocacy Coalition, which does policy and advocacy work in the legislature; sector-based work groups and ad-hoc committees. Anyone can join, and meetings occur as necessary.
CONTINUING DATA GATHERING AND ANALYSIS
The Child and Family Policy Center did a more in-depth analysis of Iowa ACEs data
from the 2013 BRFSS ACEs module. The underlying message from the data, says Lisa Cushatt, program manager for Central Iowa ACEs 360, is: “Here’s where we think kids are today. Unless we make changes now, we cannot expect the next generation to have lower ACE scores.” Integrated into the latest report, issued at the end of August 2015, was data from the Iowa Youth Survey, which has questions similar to ACE Study questions.
Members of the steering committee have been funding the various parts of Iowa ACEs 360’s work. For example, the United Way of Central Iowa funds Cushatt’s part-time position; Sarah Welch at Prevent Child Abuse Iowa to manage communications (the Iowa ACEs 360 web site), and special projects. Mid Iowa Health Foundation has supported Iowa ACEs report development and the Raising Resiliency: ACEs Response Toolkit. Prevent Child Abuse Iowa supports the upcoming Connections Matter campaign and training through a number of sources, and the online learning modules on the Iowa ACEs 360 web site. The Child and Family Policy Center has separate funding for its data analysis.
The organization’s mission is “to improve the health and well-being of all by empowering communities, organizations and people to take informed actions to prevent and mitigate the lifelong effects of childhood adversity.”
To achieve their mission, the committee has organized around six strategic areas: strengthen individual knowledge and skills, promote community education, educate providers, foster coalitions and networks, change organizational practice, influence policy and legislation.
They’re already making great strides:
Strengthen individual knowledge and skills and promote community education:
For the last three years, member organizations have been doing presentations around the state. However these presentations have been primarily focused on the professional sector, and a shift to a community approach was needed.
In June 2015, the Central Iowa ACEs 360 Steering Committee, in partnership with the Developing Brain Group and the Trauma Informed Care Project, launched Connections Matter: Developing brain * relationships * community. It’s a statewide campaign to develop a common way to talk about trauma, says Cushatt.
“All the trauma coalitions have agreed to participate,” she says.
They’re working with Dr. Linda Chamberlain, who wrote the Amazing Brain series, to develop a community-friendly curriculum and a booklet so that anyone can learn how to talk about the brain and explain how trauma can impact children.
“We’re not saying trauma is OK,” says Cushatt. “We’re saying it’s OK to talk about trauma.”
The campaign officially kicks off September 30 and October 1 with three train-the-trainer workshops “designed to arm you with the facts, stories, tools and materials to carry this message into your communities,” according to the website.
Cushatt anticipates that 300 people will attend the three-hour workshops. Participants will learn how to deliver 20-minute and 50-minute presentations at community meetings. They will be equipped with PowerPoint slides and handouts. This webinar explains how to become involved.
In August, the steering committee launched a new resource, the Raising Resiliency: ACEs Response Toolkit on the Iowa ACEs 360 website. The toolkit is designed to answer the most common question asked after an ACEs presentation: “So, what do I do about it?”
An obvious part of community education is through the media, and the ACEs work happening in Iowa has been featured in:
KCWI’s Great Day in Iowa – A morning TV show that dedicated a segment to Iowa’s ACEs program
“We need to move into more sector-based work,” says Cushatt. “It’s great that we can continue to educate on ACEs, trauma, and resilience. We need to take that step further, creating movement in systems to affect change. Knowledge is power, but we need to put knowledge into practice.”
To support that approach, Central Iowa ACEs 360 is developing a series of sector-specific white papers, says Cushatt. They will focus on education, primary care, early education, the faith community, and include background research, best practices, and five specific action steps.
Iowa Dept of Public Health is rolling out the Lemonade for Life program. Originally designed for home visitation, now it’s useful for anyone who works with families. People participating in the program have been trained to educate parents about ACEs, have them do their own ACE scores, and help them create a plan to prevent ACEs in their kids.
Foster coalitions and networks:
Central Iowa ACEs 360 has been the driving force in educating and integrating ACEs research in the state, and certainly in the legislature. However, its primary geographic focus is on the area in and around Des Moines. In a state-wide meeting at the beginning of the year, people from all parts of Iowa gathered to talk about how to foster successful activities in other regions, and how to work with each other to support those efforts.
Steering committee members participated in the Midwest Regional Summit on Adverse Childhood Experiences in Chicago.
University of Iowa began offering grants to community-based organizations to implement evidence-based programs that support healthy development of children. It also began awarding grants to University of Iowa investigators that helped promote the further understanding of ACEs.
Change organizational practice:
More than a dozen organizations are integrating trauma-informed and resilience-building practices based on ACEs research writ large (the epidemiology of ACEs, the neurobiology of toxic stress, the long-term biomedical and epigenetic consequences of toxic stress, and resilience research).
One example is Youth Emergency Services and Shelter (YESS), a nonprofit organization that serves 1,000 children each year – newborn to age 17 – with emergency shelter, crisis intervention, and counseling. YESS staff are asked to measure their own ACEs and discuss how personal trauma can impact their work. Staff are also encouraged to focus on self-care, with reimbursements for gym memberships and race registrations, a library open to all employees, and opportunities for social outings.
To help shape treatment and care, children are measured for ACEs when they arrive at YESS. According to the description on the Central Iowa ACEs 360 web site: “The clinical team uses positive reinforcement instead of negative consequences for behavior and has added alternative therapies including music, drama, dance and art. Staff are encouraged to practice positive role modeling. For example, in addition to all children writing a safety plan when they arrive at the shelter, all staff also have their own safety plans.”
Influence policy and legislation:
The Iowa ACEs Advocacy Coalition, one of Central Iowa ACEs 360’s groups, has had a busy 2015.
- In January, its members did a presentation about ACEs for the Iowa Senate Human Resources Committee and asked committee members to provide leadership in policymaking to prevent ACEs and promote resiliency.
- In February, its members did a presentation for the Iowa House Human Resources Committee. They provided an overview of ACEs research, including the neurobiology of toxic stress, how public and private organizations in Iowa were working together to prevent ACEs, and information about successful evidence-based programs in Iowa. Also in February, the coalition issued a policy brief that looked at primary prevention, ACEs screening, targeted interventions, and evidence-based treatments. You can find the policy brief here.
- In March, members from Central Iowa ACEs 360 and the Iowa ACEs Advocacy Coalition participated in NAMI-Iowa’s Day on the Hill, educating Iowa legislators on the impact of childhood trauma on the long-term health and well-being of Iowans.
- In May 2015, the coalition advocated for legislation that would spend $3.3 million to expand 1st Five to create a children’s mental health and well-being work group, and increased access to affordable childcare (from 145% to 160% FPL).
“We’ve laid the ,” says Cushatt. “We’re really starting to see some movement and leadership from elected officials who understand that we need to look at policies and change policies to be better for kids and families. We’re starting to see a lot of leadership.”
One example is of that leadership is an op-ed in the Des Moines Register written by Iowa State Senator Matt McCoy (Des Moines) in which he highlighted the life-long impact of childhood trauma.
Iowa Timeline - Click Year to View Highlights
Robert Anda does presentation about CDC’s ACE Study at the Early Childhood Iowa Congress; 300 people hear about the research, many for the first time
Ad hoc steering committee begins meeting; Department of Public Health agrees to include ACE survey in state’s BRFSS (Behavioral Risk Factor Surveillance System), partially paid for by Mid Iowa Health Foundation
Anda invited back for first Iowa ACEs Summit, an invitation-only meeting of stakeholders; 200 people attend
Central Iowa ACEs 360 Steering Committee founded, with about thirty people; group begins meeting, plans second ACEs Summit and makes commitment to do three years of ACE surveys
Second ACEs Summit open to anyone in state. Anda and Laura Porter, former director of Washington State Family Policy Council, are major speakers; 800 people from eighty percent of Iowa’s counties attend. Focus is basic information: “ACEs 101”
Third ACEs Summit. Sold-out attendance; 625 people gather to talk about next steps. Steering committee presents first Iowa ACEs survey from 2011 data
Trauma-informed/resilience-building practices start to be implemented in schools, homeless shelters, prisons, mental health treatment and communities
Fourth state summit focuses on ACEs: 2014 Child Abuse Prevention and Family Support Conference hosted by Iowa Department of Public Health and Prevent Child Abuse Iowa. The three-day conference attracts 500 people. Workshops focus on how to use ACEs research in practice.
ACEs Iowa creates online learning module for ACEs and trauma-informed/resilience-building practices; Prevent Child Abuse Iowa starts “Community-based prevention response to ACEs” initiative.
Iowa Legislature allocates $50,000 to cover collection and analysis of 2015 ACE data through BRFSS.
Steering committee members and people from Iowa regions create group on ACEsConnection.com.
Developing Brain, Developing Accountability conference for educators and people in the criminal justice systems, to look at how brain science informs current punitive measures, and at new concepts to help youth succeed.
Central Iowa ACEs 360 members do presentation about ACEs for the Iowa Senate Human Resources Committee.
Central Iowa ACEs 360 members do presentation for the Iowa House Human Resources Committee.
The Central Iowa ACEs 360 coalition advocates for legislation concerning children’s mental health and increased access to affordable childcare.
Leaders from across Iowa gather for Coordinating Iowa’s Response to Adverse Childhood Experiences meeting to discuss statewide collaboration.
Central Iowa ACEs 360 Steering Committee approves a strategic plan for 2015-2016 and a new coalition structure.
Central Iowa ACEs 360 Steering Committee, the Developing Brain Group and the Trauma Informed Care Project, launch Connections Matter: Developing brain * relationships * community, a statewide campaign to develop a common way to talk about trauma.
Child and Family Policy Center releases a report with more in-depth analysis of Iowa ACEs data from the 2013 BRFSS ACEs module.
Raising Resiliency: ACEs Response Toolkit on the Iowa ACEs 360 website. The toolkit is designed to answer the question: “So, what do I do about ACEs?”
Three hundred people attend three train-the-trainer workshops to provide them with the facts, stories, tools and materials to carry message of Connections Matter: Developing brain * relationships * community to their communities.