An Academic-Community Partnership to support a local community - - PowerPoint PPT Presentation

An Academic-Community Partnership to support a local community initiative focused on addressing adverse childhood experiences (ACEs) in rural Appalachia: The story of the Watauga Compassionate Community Initiative

Adam Hege, PhD, MPA, CHES Kellie Reed-Ashcraft, PhD, MSW Crystal Kelly, MSW Jennifer Warren, MA Denise Presnell, MSW Erin Bouldin, PhD, MPH Kayla Forliti, BSW

Disclosure of personal relationships with a commercial interest

Objectives

• 1. Provide overview of Watauga County and some key foundational

statistical indicators

• 2. Describe the history and development of the Watauga Compassionate

Community Initiative (WCCI)

• 3. Discuss the academic-community partnership that has been developed
• 4. Identify strengths, challenges and opportunities for

academic-community based partnerships focused on ACEs

Watauga County, North Carolina

• Located in southcentral portion of the Appalachian region
• Home to a large regional public university (Appalachian State)
• Serves as leader and central hub for “High Country”
• High poverty and adverse social determinants of health
• Primary challenges include food insecurity, mental illness, and

substance abuse

Watauga County, North Carolina

Census Community Facts, Watauga County (2013-2017 5-Year Estimates) Indicator Measure Population Median Age Median Household Income Individuals below poverty level White alone 53,421 30.6 $41,541 28.3% 51,228 (95.9%)

https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml?src=bkmk

Watauga County, North Carolina

County Health Rankings, Watauga County (2019) Indicator Watauga County North Carolina Poor mental health days Frequent mental distress Food insecurity Uninsured children Income inequality Excessive drinking Severe housing cost burden 4.5 (past 30 days) 14% 18% 7% 7.4 (ratio) 20% 22% 3.9 (past 30 days) 12% 15% 5% 4.8 (ratio) 17% 14%

https://www.countyhealthrankings.org/app/north-carolina/2019/rankings/watauga/county/outcomes/overall/snapshot

Adverse Childhood Experiences (ACEs)

• Seminal study by Felitti and colleagues in the late 1990s brought

about awareness of the importance of adverse childhood experiences (ACEs) as it pertains to health outcomes and wellbeing across the lifespan

• Their study questions are still used today and focus on such issues

as abuse (physical, mental, sexual, etc.) and household dysfunction (substance abuse in the household, mental illness, parent abuse, etc.) that one experiences before the age of 18

• ACEs linked with poverty and numerous other social determinants
• f health
• https://www.cdc.gov/violenceprevention/childabuseandneglect/aces

tudy/index.html

Community Approaches to Address ACEs

• Washington state has been at the forefront and is a leader and model for

initiatives focused on ACEs

• ACEs Connection has over 35,000 members

https://www.acesconnection.com/

• Building Community Resilience Model developed by Ellis and Dietz at

George Washington University, which centers on four key components:

• a. shared understanding of ACEs and their effects at the community level
• b. building sense of readiness through capacity building
• c. developing innovative cross-sector partnerships bridging the gaps

between clinical and community care (primary, secondary, and tertiary prevention)

• d. developing a more engaged community that has support systems and

leadership it needs to thrive

Watauga Compassionate Community Initiative (WCCI)

• In 2014, a group of child and youth-serving organizations came

together to explore how the community could better serve children, youth and their families

• Executive Director (Jennifer Warren) of a local nonprofit attended a

large Adverse Childhood Experiences (ACEs) Summit in Asheville, NC in 2015

• Social Worker (Denise Presnell) from local school system interned

with the nonprofit in 2016, leading to a partnership to better disseminate ACEs information in the schools and in the broader community

• The larger group decided to use direction from the Centers for Disease

Control and Prevention’s (CDC) “Essentials for Childhood” to inform their ongoing efforts, focusing on raising community awareness and providing education around trauma, ACEs, resiliency

Watauga Compassionate Community Initiative (WCCI)

• Held first “State of the Child” Conference in spring 2017
• After the 1st conference, the first “official” meeting took place with

around 60 people in attendance

• The group meets monthly to work on goals and is broken into

subcommittees: Awareness; Prevention; Data; Funding; Policy; and Events

• The vision is: “for Watauga County to be a relationship-driven,

compassionate, and resilient community that is knowledgeable, inspired and empowered to prevent harm, promote wellbeing, and health from adversity

• The mission is: “to promote health and resiliency in our community and

to effectively prevent, recognize and treat trauma by creating safe, stable, nurturing environments and relationships through advocacy and policy change

Watauga Compassionate Community Initiative (WCCI)

In using the Essentials for Childhood as the framework and model for the initiative, there are four primary goals. 1. Raise awareness and commitment to promote safe, stable, nurturing relationships and environments and prevent child abuse and neglect 2. Use data to inform actions 3. Create the context for healthy children and families through norms change and programs 4. Create the context for healthy children and families through polices

Key Accomplishments: Raising Awareness

• Developing a WCCI business card with several crisis resources for

emergency responders to utilize

• Developing an informational presentation board housed at local public

library

• Speaking to numerous community groups to include: faith-based

institutions, in university classes, service groups (firefighters, police

• fficers/sheriff, medical), and the newspaper and other media sources
• Hosting annual “State of the Child” Conference with increased

attendance each year

Key Accomplishments: Using Data to Inform Action

• Developing an interactive GIS resource map of the community
• Tracking of presentations data – who, what, type, size, etc.
• Making use of state and community level data to include: Behavioral

Risk Factor Surveillance System (BRFSS) and Youth Risk Behavior Survey (YRBS)

• Measuring ACE scores and resiliency among members of WCCI

Key Accomplishments: Changing Norms & Policies

• Trauma-Informed Schools and School System/Compassionate Schools
• Collaborating with local law enforcement and judicial agencies to

consider ACEs and trauma when interacting with people at time of arrest, during sentencing, and upon incarceration

• Aiming for implementation of universal home visiting program for

families in the county to provide early support and intervention if needed

• Appalachian State University offering course in Trauma-Informed

Care, which focuses on developing health-related professionals ready to prevent and treat trauma at the individual, family, and community levels

• Faith community has expressed significant impacts on their members
• The High Country United Way including ACEs and the prevention of

childhood trauma as one of its funding priorities

• Local counties starting initiatives focuses on ACEs

Key Accomplishments: Funding

• Pursuing grants and research collaboration with university professors

from Social Work, Public Health, Nursing, and Education; the mix of the WCCI membership involves community practitioners and faculty from Appalachian State University

• Funding and in-kind donations from local businesses and social service

agencies to include High Country United Way, Juvenile Crime Prevention Council, and Watauga Education Foundation

Lessons Learned: Insights for other communities implementing an ACEs initiative

Strengths: 1. Powerful change happens when skilled professionals and community members work collaboratively, particularly when each has long-term commitments and ties to the community 2. Co-leaders (Denise Presnell and Crystal Kelly) are inclusive and collaborative, communicate well, and recognize the skill sets of each member 3. Interdisciplinary perspective for problem-solving is critical – everyone’s “voice” matters 4. Data-driven approaches can effectively guide decision making and goal setting 5. Lack of funding doesn’t have to be a deterrent 6. University-community partnerships offer a good strategy for sharing

• f resources

Lessons Learned: Insights for other communities implementing an ACEs initiative

Challenges/Barriers: 1. Developing a strategic plan and longer over-arching goals 2. Goals to guide data collection 3. Time commitment, lack of staff support, lack of funding, and the misalignment of systems must continually be addressed 4. Prevention efforts, particularly primary prevention, are often under-resourced and under-valued 5. Grassroots efforts provide a great deal of energy, but attention must be placed on efforts and role clarity 6. Community members most impacted by ACEs must have a continued voice and presence in community efforts

Future Goals and Directions of WCCI

1. Moving upstream in thinking and action among agencies and leaders 2. More involvement in advocacy and communication with elected

• fficials and policymakers

3. More active participation from the medical community, which includes local pediatricians and other healthcare providers 4. Seeking funding opportunities to help expand the current work 5. More commitment from the faculty/staff and resources of Appalachian State University

Questions??