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Changing the Culture in Tennessee:
Promoting ACEs Philosophy and Transforming Organizations
Presented by:
Sissie Hadjiharalambous, PhD
Emily McCutcheon, MSSW, MBA, LMSW
Linda Daugherty, MPA
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
What are ACEs and why do they matter?
The Adverse Childhood Experiences Study
(1998)
Vincent Felitti, et.al.
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
(Source: CDC)
Early Life Stress Impacts Life-long Health & Development
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
(Source: CDC)
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
(Source: CDC)
Tennessee's Response: BSB Initiative
ACEs Coordinating Team
Representatives from public and private sectors
Public Sector Steering Group
Representatives from key state departments:Children’s Services; Education; Health; Human Services; Intellectual and Developmental Disabilities; Mental Health and Substance Abuse Services; and from the TennCare Bureau; and Commission on Children and Youth
Private Sector Steering Group
Representatives of:ACE Awareness Foundation; Casey Family Programs; Healing Trust; Health Care Funders; Key Service Providers; Medical Community; ReadyNation – Tennessee; Provider Organizations; Trade Associations; United Ways
INNOVATION TEAMS
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
BSB KEY STRATEGIES
•Knowledge Mobilization
• Investing in Local Solutions for Innovation
•Measurement of Impact
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Strategy 1: Knowledge Mobilization
• Translating Brain Science using metaphors that are easily understood to raise awareness• Brain architecture
• Serve and return
• Toxic stress
• Air traffic control
• Creating common language to inform action across sectors
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Use of Metaphors - Resilience
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Strategy 2: Support Innovative Solutions
• Competitive application process under guidance of Three Branches Institute• 13 innovations funded in 2017
• 8 new innovations funded in 2018; 8 continued from FY17
• Identify most effective strategies for preventing and mitigating ACEs that can be replicated
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
ACEsEDUCATION
**
*
TARGETED REFERRALS
DIRECT
INTERVENTION/ ***SERVICE PROVISION
* *
**
CURRICULUM DEVELOPMENT
*
*
*
ACEs SCREENING
SECTORS:• Medical• Education• Early
Childhood/ Childcare
• Community• Academia
Innovations
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Frontier Health - Cultivate Hope, Educate Resilience, Identify Supports, Heal (CHERISH)
ACEsEDUCATION
DIRECT INTERVENTION/SERVICE PROVISION
TARGETED REFERRALS
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Baptist Memorial Hospital for Women - ACE Healthcare Provider Educational Program
ACEsEDUCATION
TARGETED REFERRALS
CURRICULUMDEVELOPMENT
ACEs SCREENING
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Discover Together - Chronic Absenteeism Community Ambassador
DIRECT INTERVENTION/SERVICE PROVISION
TARGETED REFERRALS
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Strategy 3: Measure Impact
• Evidence from FY17 funded innovations
• Public awareness baseline survey
• How people and organizations are using ACEs message and brain science to transform culture
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Evidence from 13 Innovations
•What has worked well?
• Early involvement of key stakeholders and identification of champions• Enhancing or augmenting existing programs•Clarifying targets, goals, underlying logic
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
What were challenges?
• Lack of formal agreements
• Logistical challenges
• Lack of integration of program evaluation activities in program operations
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Results from Public Awareness Baseline Survey
56%
16%
14%
6%
3%5%
Level of Familiarity with ACEs
Not at all A little Somewhat
Very Extremely Not sure
75%
14%
6%6%
Level of Familiarity with BSB
Not at all Somewhat Very Not sure
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Trends Across Demographic Groups
• Persons over the age of 64 were more aware of the impact of childhood experiences on adult well-being. However, they were not as aware of the impact of ACEs on brain development.
• Females more likely than males to recognize impact of ACEs on brain development and adult well-being.
• African Americans and persons living in low-income households were more likely to disagree that ACEs impact high school graduation rates, divorce rates, and future reliance on public assistance.
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Using a "New Lens" - Inclusion of ACEs Philosophy and Information for all Staff Training and Development
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
“Because of the training and awareness ... in relation to ACEs, the court has
focused even greater attention to
investigating what is happening to the children who come into our court and
what type of service can we provide to break the cycle of ACEs in that family.”
“I utilize it to help staff
think about how they are supporting one another -- building
safety, emotional safety in the work environment.”
“I trained Client Representatives who work directly with TANF clients. The Client Reps have told me that this was
the most valuable training that they have had in directing their approach and interactions with their clients.”
Integrating ACEs Philosophy into Organizations and Work with Communities
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
"We are more mindful that our audience may have experienced
ACEs or work with those who have experienced ACEs so that
we are intentional in our approach to training events.”
“We have talked about the level of ACEs for each of our preschool students and the
toxic stress that they may be experiencing.
We changed how we relate to them and the words we use to help them identify
their feelings and resolve conflict.”
“Knowledge about the long term health implications resulting from
ACEs prompted our Board to adopt prevention/mitigation of ACEs as one of the two primary issue areas for our new
advocacy grants program.”
Integrating ACEs Philosophy into New Programs & Standard Operating Procedures
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
“We administer the ACE at intake and use it to
guide our services.”
“Providers and clinicians now discuss information about ACEs when determining treatment planning for
clients.”
“Resident pediatricians are recognizing
that asking about ACEs is important when assessing behavior problems.”
Continuing to Raise Awareness
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service
Disseminating Practical Ideas for Everyone – Preventing & Mitigating ACEs• Embed ACEs information on your organization's website
• Create a peace corner for children who are feeling overwhelmed
• Equip community/congregation/organization leaders with information about ACEs
• Volunteer to assist new parents or new mother
• Tutor children in an afterschool program
• Find ways to connect with children to provide safe, stable, nurturing relationships and environments – sports, scouts, theater
Prepared by the University of Tennessee College of Social Work Office of Research and Public Service