Category Archives: injury and violence prevention

Honoring Essential Agents of Change: A Partnership Strategy

By Deborah Mutschler, Massachusetts Essentials for Childhood 

Massachusetts Essentials for Childhood (MA EfC) promotes a variety of opportunities communities can employ to promote safe, stable, nurturing relationships and environments to prevent child abuse and neglect. To highlight an expansive view of partnership, MA EfC created the Essential Agent of Change Awards, which honors community groups with missions that don’t directly address child abuse and neglect prevention, but still strengthen protective factors in families and communities that support safe, stable, nurturing relationships and environments for all children and families.

While experts have successfully raised awareness about the consequences of child abuse and neglect, we can do a better job of educating the public about the factors that prevent child abuse and neglect. Since prevention efforts are focused on all children and families, it is arguable that more people could see a role for themselves in child abuse and neglect prevention when framed as promoting safe, stable, nurturing environments and relationships for everyone. When individuals understand their personal and professional interactions, as well as the policies they support, as a part of prevention efforts, they can recognize themselves as agents of change, even if child abuse and neglect fall outside their stated mission and scope of work.

The aim of Massachusetts Essentials for Childhood is to connect people to communal opportunities to prevent child abuse and neglect.  To demonstrate this concept, MA EfC created the Essential Agent of Change Awards, which honors groups whose activities strengthen one of the five protective factors described in the Strengthening Families framework (parental resilience, knowledge of parenting and child development, social connections, concrete support in times of need, children’s social and emotional competence), but do not include child abuse and neglect in their organizational missions.

For example, representing the protective factor of providing “Concrete Support in Times of Need,” an award was given to New Lease for Homeless Families for their work with large landlords in creating a mechanism which makes it easier for homeless families, who would not normally qualify for private market housing, to enter into leases.  The award helps illustrate that by providing this support to families, New Lease helps create stability and lessen parental stress. In this way, in addition to housing families, New Lease is also strengthening families and preventing abuse and neglect.

Honoring Essential Agents of Change is a strengths-based approach to raising awareness about child abuse and neglect prevention among organizations that may not be aware that their work plays an important role in prevention. The award expands the reach and importance of the work the honorees are already doing, while creating opportunities for honorees to see themselves as potential partners in ongoing prevention work. Because the program is relatively new, we can only report on early results. The first outcome is that all of the honorees are now aware of the Strengthening Families protective factors framework, and two-thirds of them said they are now more aware of the ways in which their work builds strong communities that support families and reduces child abuse and neglect. One honoree said, “Having our work recognized, reinforced that we are on a good path, showed that what we do matters to people beyond ourselves, which spurs us to future action.”

In addition, since we presented the awards at an Essentials for Childhood Summit of public health and child protection professionals, we raised awareness about potential partners whom others may not have considered working with in their communities. Furthermore, we were able to connect awardees with individuals and organizations within the child abuse and neglect prevention community, which allowed us to foster new relationships and partnerships. In a recent survey, 80% of the honorees say they have either already created new partnerships with groups that further strengthen their communities or are developing those partnerships.

The purpose of the Essential Agents of Change Awards is to make connections between people and ideas. It is clear that a positive and strengths-based approach, such as honoring organizations whose outcomes align with the missions of other service entities, can initiate productive and healthy relationships.

MA EfC believes that simply alerting groups to the relationship between their work and child abuse and neglect prevention is not sufficient, and that more effort must go into building relationships to create concrete partnerships. New relationships, new ideas, new framing, all take an effort that need nurturing, as we support adults who seek to help children.

For more details, visit Strengthening Families Protective FactorsMassachusetts Essentials for Childhood Facebook page, and ACEsConnection MA EfC page.

Colorado’s Family Friendly Workplace Approach

By Tomei Kuehl, Colorado Department of Public Health and Environment

Colorado is one of five Centers for Disease Control and Prevention Essentials for Childhood recipients and chose to focus on employer engagement as one a strategy to address child abuse and neglect prevention and promote safe, stable, nurturing relationships and environments for all children. The Colorado Essentials for Childhood project leveraged partnerships and resources to develop the Family-Friendly Workplace Toolkit, which provides employers with evidence-informed practices and policies that enhance employee health and well-being.

The Colorado Essentials for Childhood project is rooted in a collective impact approach that brings in diverse voices to the issue of child abuse and neglect prevention. A collective engagement of multi-sector partners and stakeholders allowed for the identification of a missing partner at the table: the business sector. A challenge arose in translating our values and purpose from a public health lens to one that was more business sector oriented. Another challenge was developing a set of requests for active participation in child abuse and neglect prevention from the business sector. For example, what is the role of business in child abuse and neglect? Early efforts to engage business highlighted how disparate the language between public health and business is and indicated a lack of readiness on behalf of the public health sector to have these discussions.

As a result of identifying the business sector as a missing partner in child abuse and neglect prevention and understanding the limitations of the public health sector in understanding the connections between business and child abuse and neglect prevention, the state leveraged funding from its Rape Prevention and Education program to hire a researcher to conduct a literature review and develop a toolkit. The literature review identified best practices to support worker health and well-being and the development of Colorado’s Family-Friendly Workplace Toolkit. The toolkit, which is now in its second edition, was developed through partnerships with several organizations including: Executives Partnering to Invest in Children (EPIC), Children’s Hospital Colorado, local public health departments, city governments, and others. The toolkit provides evidence-informed best practices proven to support employees with different needs, and can ultimately lead to better health outcomes for workers and their children. An additional critical partnership developed with Health Links, a program of the Center for Health, Work & Environment at the Colorado School of Public Health, and EPIC resulted in the development of a Family-Friendly Assessment. The Family-Friendly Assessment (FF+) is an organizational tool that businesses can use to identify the needs and priorities of employers in order to create environments that are supportive of families.

An outcome of developing the Family-Friendly Workplace Toolkit has been increased interest from both businesses and local partners in family friendly practices. Over 1800 hard copies of the toolkit have been disseminated to partners across the state, and the electronic toolkit has been shared with national partners as well as agencies from other states. The toolkit also resulted in the creation of business forums where leaders from the business sector, healthcare, public health, education, and others convened to learn about best family friendly practices in their fields. Colorado business leaders have shared ways that they have made their organizations more family friendly. Additionally, 55 businesses have taken the Family-Friendly Assessment offered through Health Links to assess their level of family friendly practices. The Colorado Department of Public Health and Environment (CDPHE) recently took this survey, scored well, and has been highlighted as a family friendly department within the state system. Governor Hickenlooper’s Office is encouraging each department to take the family friendly assessment, discuss variations in results, share best practices related to address equity, and increase family friendliness within the workplace.

The development of the Family-Friendly Workplace Toolkit and the Family-Friendly Workplace Assessment have been successful because they provide a meaningful mechanism to engage with the business sector in child abuse and neglect prevention. The toolkit provides case studies that can be used as a road map for other businesses interested in being more family friendly, and the assessment provides tools and coaching to help businesses implement family friendly practices. Colorado has been approached by other states interested in replicating the toolkit and using customized case studies, which would be a great way to leverage the research already done to individualize the toolkit for a state’s unique context. A lesson learned through this process is how difficult it can be to engage businesses. The Colorado Essentials project is still working to understand how to best engage businesses directly; however the toolkit and the assessment are useful tools to beginning those discussion as we strive towards more concrete business sector involvement.

For more information, visit CDPHE’s Family Friendly Workplace Assessment and Workplace Toolkit webpages.

Translating Child Adversity Data into Actionable Information

By Marissa Abbott, MPH and Steve Wirtz, PhD, California Department of Public Health

The California Essentials for Childhood (EfC) Initiative launched a new set of child adversity and resilience data indicators on Furthermore, the initiative created state and local dashboards to bring together sources of data that represent a broader set of life experiences than originally reflected in the Adverse Childhood Experiences (ACEs) study, such as living in poverty or dangerous neighborhoods. The goal was to make these data widely available and provide training on how to talk about adversity to increase local capacity for preventive action.

Child abuse and neglect (CAN) (i.e., physical, sexual and emotional abuse, and physical and emotional neglect) make up five of the original 10 ACEs and is a significant public health problem in California. In 2017, there were over 68,000 substantiated cases of CAN for a rate of 7.5 per 1,000 Californian children. In addition, approximately one in five California children live in chronic poverty and unstable housing conditions. These types of severe adversities have been shown to have negative and long-term impacts on child health and well-being. The “toxic stress” associated with these early and cumulative traumatic experiences can disrupt healthy development and lead to emotional, behavioral, and social problems. It can also lead to serious physical and mental health issues in adulthood.

Most prevention and intervention efforts have focused on providing direct services to protect children and strengthen families. Although these are critical services, this approach does not address the overarching social contexts that create the conditions in which families struggle and children are at risk for ACEs. Many California community members and leaders are not fully aware of the growing scientific consensus on the biological processes through which ACEs impact lifelong health and intergenerational outcomes. Professional and community leaders often do not have access to local data on child adversity and resilience that they can use to inform local and state decision-makers about evidence-based policy and program solutions. In addition, local partners often don’t have the communication skills to translate these data to inform local action.

The California Department of Public Health (CDPH) Essentials for Childhood (EfC) Initiative, funded by Centers for Disease Control and Prevention (CDC), aims to promote a public health framework to address child abuse and neglect and adversity by focusing on organizational and community-level change. Our goal is to strengthen efforts to create systems and norm changes that promote safe, stable nurturing relationships and environments for all children. Based on input from multiple partners, (e.g., ACEs Connection, Berkeley Media Study Group (BMSG), CDPH Maternal, Infant and Adolescent Health, First 5 California, Lucile Packard Foundation for Children’s Health, Department of Social Services’ Office of Child Abuse Prevention, Public Policy Institute of California), we developed a plan to address community requests for local child adversity data by bringing together multiple sources that tap into both family and community adversity, increasing the ease of access to these data, and providing hands-on training to increase local capacity to use these data for preventive action. The website was already a well-known, user-friendly website for child health and wellbeing indicators. We added a new “Childhood Adversity and Resilience” data topic to with not only family ACEs information, but also social and community stress indicators such as housing and food insecurity. By providing our local partners with easy access to this broader set of data and providing hands-on skills training to talk about child adversity, we were able to support their efforts to educate communities and leaders about data-informed solutions to address child adversity.

The EfC Data Workgroup has been able to:

  • Expand the trauma-informed lens beyond the original ACEs focus by identifying additional data sources that capture broader socio-ecological risk and protective factors for adversity (e.g., National Survey of Child Health).
  • Build upon the existing platform to add the first new data topic in six years on Childhood Adversity and Resilience, using three data sources to provide better statewide and county level indicators of current child adversity status.
  • Create online state and county–level dashboards with the broader set of family and community adversity and resilience indicators, along with a small list of criteria-driven risk and protective factor indicators across the life course.
  • Conduct outreach to provide hands-on trainings to local communities to disseminate the data and build capacity to use it (including application of framing techniques). Training sessions have been held in Butte (nine rural northern counties represented), Alameda (seven Bay Area counties represented), Fresno, San Bernardino, and Riverside counties.

There have also been multiple ongoing dissemination efforts for the adversity topic and the state and county dashboards on the site as well as on the ACEs Connection website and through conferences and webinars.

The California EfC Initiative is a collective impact project that requires multi-agency collaboration and alignment around a common agenda. The strength of the collaboration has allowed us to partner with ACEs Connection, Berkley Media Studies Group, First 5 California, Kidsdata and others to disseminate data with a broader public health perspective on child adversity and resilience to communities across California. It has also allowed us to focus on systems and norms change. Without these partnerships, it would have been challenging to create the data platform and disseminate adversity-related messages with a wider view of ACES that provides a stronger framework for building community based solutions, rather than simply focusing on individual interventions.

The other major lesson learned is that in order to move this project forward, it was critical to find ways to align the work with our partners’ organizational agendas. By finding opportunities for alignment, we were able to create a process and final product that met the needs of multiple groups. We consider this to be a major success and example of how a state public health agency can collaborate effectively across agencies and sectors to address the goal of safe, stable nurturing relationships and environments.

For more details, visit Kids Data for a summary of childhood adversity and resilience and the California Department of Public Health website.

SAMHSA’s National Prevention Week: Action Today, Healthier Tomorrow

May 13–19, 2018, is the Substance Abuse and Mental Health Service Administration’s (SAMHSA) National Prevention Week. NACCHO encourages local health departments (LHDs) to engage their communities in promoting mental health and substance abuse prevention efforts throughout this week. The theme this year is “Action Today, Healthier Tomorrow!”

Daily Themes

  • Monday, May 14: Promotion of Mental Health & Wellness
  • Tuesday, May 15: Prevention of Underage Drinking & Alcohol Misuse
  • Wednesday, May 16: Prevention of Prescription & Opioid Drug Misuse
  • Thursday, May 17: Prevention of Illicit Drug Use & Youth Marijuana
  • Friday, May 18: Prevention of Suicide
  • Saturday, May 19: Prevention of Youth Tobacco Use

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Responding to Youth Violence as a Public Health Problem

By Linda McGlone, MPH, STRYVE Coordinator, Monterey County Health Department, California

Looking at youth violence through a public health lens, the Monterey County Health Department contributed to violence reduction by offering their skills in data, strategic planning, and the public health approach.

In 2011, Salinas, California was a small city with a big city problem: gang violence. The violent crime rate for Salinas was 732.5 crimes per 100,000 residents – higher than Los Angeles’ rate of 522.4. For decades, gang-related shootings caused most of the city’s violent injuries. Monterey County had the highest rate of youth homicides in California in 2009, 2010, 2012, and 2013. Salinas is a city of 150,854 residents, 75% of whom are Hispanic or Latino. This is a young community, with a high percentage of families living below the federal poverty level, organizing to become a healthy and thriving community. The Monterey County Health Department (MCHD) recognized youth violence as a public health problem, and we saw that primary prevention was lacking from the community’s response. How could this perspective gain traction in a discussion led largely by law enforcement? Continue reading

Public Health Policy: What to Watch in 2018

NACCHO’s government affairs team has provided a forecast of what to expect in public health policy in 2018. The decisions made in Washington this year will have a major impact on local health departments and on the public’s health. As always, NACCHO members and staff will work together this year to be the voice of local health departments. Below is a short list of the top things to watch this year. For the full list, go to Continue reading

The Opioid Epidemic in 2018: Where Do We Go from Here?

By Ian Goldstein, Government Affairs Specialist, NACCHO

The Centers for Disease Control and Prevention (CDC) estimates that 91 people die daily due to an opioid overdose. The Trump Administration has declared curbing the opioid epidemic a major priority. In March 2017, the White House created the Commission on Combating Drug Addiction and the Opioid Epidemic, headed by New Jersey Governor Chris Christie. The President proclaimed a public health emergency in late October 2017, however, such a declaration does not allocate any additional funding towards efforts to control the epidemic. On November 1, 2017, the Commission sent a report to the President with 56 recommendations the Administration can take to combat the growing opioid crisis. Some of those recommendations include an expanded drug court system, educational requirements for prescribers, and a media blitz to spread the word about preventive services and treatment availability for substance use disorder. Moreover, the Administration’s Council of Economic Advisors now puts the cost of the epidemic at $504 billion. Continue reading