Technical Packages in Injury and Violence Prevention to Move Evidence Into Practice: Systematic Reviews and Beyond

Leveraging Surveillance and Evidence: Preventing Adverse Childhood Experiences Through Data to Action

Adverse childhood experiences are potentially traumatic events that occur in childhood that have been associated with lifelong chronic health problems, mental illness, substance misuse, and decreased life opportunities. Therefore, preventing adverse childhood experiences is critical to improving health and socioeconomic outcomes throughout the lifespan. The Preventing Adverse Childhood Experiences: Data to Action (CDC-RFA-CE20-2006) funding initiative is a comprehensive public health approach to adverse childhood experience prevention that aims to understand the prevalence of and risk factors for adverse childhood experiences among youth, track changes in adverse childhood experience prevalence over time, focus prevention strategies, and ultimately measure the success of those evidence-based prevention strategies. Recipients will achieve the goals of the initiative by leveraging multisector partnerships and resources to: (1) enhance and build infrastructure for state-level data collection, analysis, and application of adverse childhood experiences related surveillance data; (2) implement at least 2 prevention strategies based on the best available evidence to prevent adverse childhood experiences; and (3) undertake data to action activities to leverage statewide surveillance data to inform and tailor adverse childhood experience prevention activities. Since the start of this initiative, recipients have focused on building surveillance capacity based on the needs of their individual states; implementing strategies and approaches based on the best available evidence to better prevent adverse childhood experiences; and ultimately improve the mental, physical, and social well-being of their populations. Although evaluation of Preventing Adverse Childhood Experiences: Data to Action is ongoing, this article outlines the current recipient surveillance, prevention, and data-to-action implementation efforts.

Preventing Childhood Adversity Through Economic Support and Social Norm Strategies

Through the Essentials for Childhood program, the Centers for Disease Control and Prevention funds 7 state health departments (states) to address the urgent public health problem of adverse childhood experiences and child abuse and neglect, in particular. Through interviews and document reviews, the paper highlights the early implementation of 2 primary prevention strategies from the Centers for Disease Control and Prevention's child abuse and neglect technical package with the greatest potential for broad public health impact to prevent adverse childhood experiences-strengthening economic supports and changing social norms. States are focused on advancing family-friendly work policies such as paid family and medical leave, livable wage policies, flexible and consistent work schedules, as well as programs and policies that strengthen household financial security such as increasing access to Earned Income Tax Credit. In addition, states are launching campaigns that focus on reframing the way people think about child abuse and neglect and who is responsible for preventing it. State-level activities such as establishing a diverse coalition of partners, program champions, and state action planning have helped to leverage and align resources needed to implement, evaluate, and sustain programs. States are working to increase awareness and commitment to multisector efforts that reduce adverse childhood experiences and promote safe, stable, nurturing relationships and environments for children. Early learning from this funding opportunity indicates that using a public health approach, states are well positioned to implement comprehensive, primary prevention strategies and approaches to ensure population-level impact for preventing child abuse and neglect and other adverse childhood experience.

Making Evidence-Based Interventions Relevant for Users: A Comparison of Requirements for Dissemination Readiness Across Program Registries

This study compares prevention program registries in current use on their level of support for users seeking to implement evidence-based programs. Despite the importance of registries as intermediaries between researchers and the public, and although previous studies have examined how registries define their standards for methodological soundness and evidence of efficacy, little research has focused on the degree to which registries consider programs' dissemination readiness. The result is that registry users are uncertain whether listed programs and their necessary support materials are even available for implementation. This study evaluates 11 publicly and privately funded prevention registries that review the evidence base of programs seeking to improve child health and prosocial outcomes on the degree to which they use dissemination readiness as an evidentiary criterion for rating programs, and the extent and type of information they provide about dissemination readiness to support real-world implementation. The results show wide variability, with few having standards about dissemination readiness or making evidence-based information about interventions easily accessible to users. Findings indicate the need for registries to (1) do more to assess dissemination readiness before including programs on their website and (2) offer more complete information on dissemination readiness and implementation support to users.

Increases in United States life expectancy through reductions in injury-related death

BACKGROUND

During the previous century the average lifespan in the United States (US) increased by over 30 years, with much of this increase attributed to public health initiatives. This report examines further gains that might be achieved through reduced occurrence of injury-related death.

METHODS

US life tables and injury death rate data were used to estimate potential increases in life expectancy assuming various reductions in the rate of fatal injuries. Corresponding numbers of deaths potentially averted annually were also estimated; unit (per death) medical and lifetime work loss costs were employed to estimate total costs potentially averted annually.

RESULTS

Through elimination of injury as a cause of death, average US life expectancy at birth could be increased by approximately 1.5 years, with notable variations by sex, ethnicity, and race. More conservatively, average life expectancy at birth could be increased by 0.41 years assuming that the national injury death rate could be brought into line with the lowest state-specific rate. Under this more conservative but plausible assumption, an estimated 48,400 injury deaths and $61 billion in medical and work loss costs would be averted annually.

CONCLUSIONS

Increases in life expectancy of the magnitude considered in this report are arguably attainable based on long-term historical reductions in the US injury death rate, as well as significant continuing reductions seen in other developed countries. Contemporary evidence-based interventions can play an important role in reducing injury-related deaths, such as those due to drug overdoses and older adult falls, as well as suicides.