Lesson 1

March 4 2020

Course – Lesson 1: XI. Next Steps

YOUR ASSIGNMENTS

LESSON 1:XI – After A Short Breather, We Have Some Homework For You

What are lesson assignments and next steps?

Your steps may be different depending on your situation. Ideally, you are taking this course as part of a cohort — a group made up of local 100% New Mexico initiative participants. You may be the co-community organizer, action team leader or member. This is ideal, as you can discuss the course and all the information presented with people you’ll be collaborating with. However, you might be taking this course because you wish to start a 100% New Mexico initiative and today, you are a solo champion seeking to recruit stakeholders. Either way, the following steps enrich your learning experience and prepare you for Lesson 2: Assess.

Visit the Virtual Innovation Center

We provide you with links to innovations in all ten key family-serving sectors. These innovations include a menu of various projects, from across the state, nation and globe to consider implementing. The projects identified are designed to strengthen family health, safety and learning systems — and support your local 100% Community innovation.

Reviewing your course textbooks

Ideally, you have a good supply of sticky notes and sharpie pens to make comments and questions throughout all books. This makes group discussion more lively and focused as you get answers to questions and challenge assumptions. In some localities, book clubs are organized around Anna, Age Eight and 100% Community with work “lunch and learns” focused on discussing Adaptive Leadership.

Reading Assignment

Course participants should finish reading Anna, Age Eight before starting Lesson: 2. Assess. Anna’s story was a wake up call for many leaders and the catalyst for the movement to ensure trauma-free childhoods. It’s a story worth discussing with your family, friends, co-workers and 100% New Mexico initiative partners.

Convene with fellow initiative participants to discuss this lesson and the assessment process

Ask the co-community organizers about the status of the Resilient Community Experience Survey. The data provided by the survey guide the assessment work.

RETURN

Lesson 1: X

DATA’S POWER

Lesson 2: I

ASSESS

March 4 2020

Course – Lesson 1: X. Data Guide Us

Institute StaffLesson 1

DATA GUIDE US

ASSESS PLAN ACT EVALUATE

LESSON 1:X – CONTINUOUS QUALITY IMPROVEMENT IS OUR GUIDING FRAMEWORK

CQI and the overall initiative

Every aspect of the initiative is guided by the four-step, data-driven process of Continuous Quality Improvement (CQI). You can see how CQI guides the broader development of the county initiative following a process of assessing, planning, acting and evaluation.

CQI and the action team projects

Below, we show how this four-step CQI process also guides the design and implementation of each project developed by an action team.

Assessment

In this first phase, we use data to identify the challenges facing children, youth and families — focused on your particular innovation area. For example, the parent and youth survey may have revealed that 50% of residents lack access to behavioral health care.

We then assess the current capacity of programs and services, like behavioral health care, to address the challenges.

Key Tasks

Identify the challenges to be addressed (For example, lack of behavioral health care that is easy to access for students and their parents)
Use data to better understand the problems and solutions. (For example, where does behavioral health care exist in the schools, community and health care settings? How affordable is it?
Use data to determine priorities.(For example, would more access be provided if the action team focused on working to create a school-based behavioral health care center at the middle school that served both students and parents?)
Use data to drill down to root causes of the challenges. (For example, might the root cause of lack of access to behavioral health care be that most leaders in the school, community and elected bodies believe that people should be able to fix themselves without professional help?)

Planning

In this second phase, we research evidence-based solutions to the problems you seek to solve. We also focus on how to develop partnerships, effective communication and countywide collaboration.

Key Tasks

Research evidence-informed solutions to the challenges.(For example, how have some schools been able to become full-services community schools with school-based behavioral health care centers serving students and families?)
Identify a timeline, roles and responsibilities, costs and other elements related to the overall implementation of the problem-solving process. (In the example case, solving the problem of lack of access to behavioral health care required funding and recruiting staff for a school-based behavioral health care center)
Develop a hypothesis and logic model that outlines the theory of change and how progress will be measured.(For example, a hypothesis could be: If we provide easy-to-access behavioral health care at schools, where youth are already present, we can increase the use of counseling for youth and their families to address challenges associated with ACEs, trauma and social adversity)
Articulate a plan consistent with the logic model. (Here is where the action team turns data into action, by making the plan to begin community dialogue about the need for a school-based behavioral health care center. This leads to a series of actions over the next year to build support and then literally build the center, assuming buy-in is achieved. All the steps are written in the one page logic model.

Action

In this third phase, we follow the plan to implement strategies shown to reduce and treat problems. This process requires short and long term work, using data to monitor progress.

Key Tasks

Secure buy-in from key stakeholders and those who may be impacted by the process of problem-solving.(For example, to build a school-based behavioral health care centers will mean buy-in from school district, school site staff, educators, parents and youth. For funding, it might require buy in from city, county and state elected leaders. A local hospital may also be a potential partner to secure buy in and funding from.
Begin implementation of solutions.(Here is where your logic model can evolve into a broader strategic plan to guide the short, intermediate and long term work.
Monitor activity in the plan and make adjustments as needed. (The action team guiding this work will need to be vigilant to ensure the project stays on track, on budget and meets expectations of the entire school community.)
Ensure data are collected throughout the action phase. (Surveys on school community member’s beliefs about behavioral health care might be useful)

Evaluation

In this fourth phase, we use data to measure the effectiveness of our actions, how agencies are being supported and how our children, youth and families are being served.

Key Tasks

Analyze all relevant data gathered during the action phase. (For example, surveys and informational interviews as buy-in evolves and funding is secured will be useful. This information can guide future action teams if they choose to tackle a similar challenge at another school.

Identify the strengths and weaknesses of the problem-solving process.
Assess the impact of the problem-solving process on the challenge (this would be a good time to re-deploy the Resilient Community Experience Survey).
Communicate the results of the problem-solving process with all stakeholders.

RETURN

Lesson 1: IX

INNOVATE

Lesson 1: XI

NEXT STEPS

March 4 2020

Course – Lesson 1: IX. Innovate

Institute StaffLesson 1

INNOVATE

SOLVING LOCAL CHALLENGES

LESSON 1:IX – How were addressing gaps in vital services

What types of innovations are we designing?

There are ten action teams, each focused on one of ten surviving and thriving service sectors. The Resilient Community Experience Survey will provide detailed data about where there are gaps in services as well as what the barriers to the services are. We provide each sector with ten innovation areas that serve as umbrellas for a variety of local projects for you to choose from based on the needs identified through the survey. These projects are how we grow our ten surviving and thriving sectors, ensuring their accessibility, quality and overall user-friendliness.

Innovation areas:

Tracking supply and demand within a particular service area (like food, housing, medical care, etc)
Ensuring current programs are fully supported
Engaging the private sectors in supporting innovations within a particular sector (to increase quality and accessibility)
Harnessing the power of technology to create a directory to services and other resources
Generating public awareness and engagement
Making sure your education system is onboard
Ensuring local higher education is engaged in research, solutions and evaluation
Supporting city and county government programs in a particular sector
Identifying how the federal and state levels can strengthen local services
Developing a City Department to oversee the quality and accessibility of a particular service areas (like housing, food, medical care, etc)

RETURN

Lesson 1: VIII

OUR SURVEY

Lesson 1: X

DATA’S POWER

March 4 2020

Course – Lesson 1: VIII. Our Survey

Institute StaffLesson 1

OUR SURVEY

UNDERSTANDING FAMILIES’ NEEDS

LESSON 1:VIII – What’s the Resilient Community Experience Survey?

We’re asking parents and youth about access to services

This survey, published in Anna, Age Eight, assesses a parent’s or youth’s access to vital services, including trauma-informed behavioral health care. In cities committed to data-driven and cross-sector ACEs prevention, we would assess people for their (and their family’s) capacity to access family-friendly services. The survey has been implemented in a number of New Mexico counties in both English and Spanish. The survey is also being adapted to be used with youth.

The role of the survey in the 100% New Mexico initiative

Two simple questions can tell you how family friendly your cities, towns and communities are.
In your county, what percentage of families have access to ten vital services for surviving and thriving ?

For those who can’t access these vital services, why?

Our parent and youth survey provides you with the answers to these questions, including how inaccessible services are, as well as why and where. These data can guide your 100% Community efforts to ensure that all families have access to the services shown to ensure trauma free and thriving children and parents.

RESILIENT COMMUNITY EXPERIENCE SURVEY

How do you rate the following services in your community? The term “accessible” means affordable and/or not a burden to get to, and not subject to long waiting lists.

Mental health care services to provide counselors to speak with about emotional problems, treat depression and untreated mental health challenges, and address adverse childhood experiences and trauma

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Medical and dental care to increase health, resiliency and longevity

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Housing programs to prevent homelessness and provide a safe place if a home is unsafe

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Food pantries and programs to reduce hunger

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Public transport that ensures residents get to vital social services, work or school

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Job training to provide access to jobs with livable wages

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Early childhood programs that strengthen early learning

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Family-centered schools. (Schools that offer support with academics, tutoring, family support, and health and social services, and do so before, during and after school, on weekends, and over summer break. They also offer counseling services and can screen students and family members for emotional trauma and mental health challenges, or refer them to local behavioral health care agencies.)

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Parent supports, including home visitation and respite programs, to strengthen families and reduce the chance of childhood injury, trauma or maltreatment

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know
Youth mentors to provide strong role models and support for every boy and girl

Very accessible / Accessible / Not very accessible / Not Accessible / Don’t know

RETURN

Lesson 1: VII

WHAT’S CQI

Lesson 1: IX

INNOVATE

March 3 2020

Course – Lesson 1: VI. Models Guiding Us

Institute StaffLesson 1

FRAMEWORKS

MODELS GUIDING US

LESSON 1:VI – Q+A with authors Katherine Ortega Courtney, PhD and Dominic Cappello

How does the research focused on the social determinants of health guide the 100% New Mexico initiative?

Dominic Cappello responds:

The social determinants of health are the conditions in the environments in which people are born, live, learn, work, and play that affect health, safety, resilience and risks. These are social, economic and physical conditions. Resources such as a health center, behavioral health care agency or early childhood learning program (the ten vital service sectors we focus on with our innovations) can create resilient community conditions and improve the quality of family life. Access to quality education, mentoring, stable food and housing have a significant influence on the health outcomes of children and parents.

Examples of resources that impact social determinants include health care, education, and a variety of user-friendly supports for children, youth and adults. Our entire initiative is focused on such vital services and include what we call the “survival services” which include: safe, affordable housing, local food markets, food programs and food pantries to reduce food insecurity, behavioral health care services, health care services including medical and dental care and transportation to vital services, education and work.

Still listed among services that determine one’s heath would be the five services we call the “thriving services.” They include: parent support programs like home visitation, quality child care and parent education, and early childhood learning programs.

A key service that can serve as the hub to most of our surviving and thriving services are Fully-resourced community schools where parents are welcomed and behavioral health, medical and dental care exists. Add to the list youth mentor programs and job training programs that are in alignment with local current and future job markets.

The social determinants of health also include social norms and attitudes (e.g., sexism, racism, and barriers to success based on low household incomes). Health disparities, concentrated poverty and the disempowering conditions that accompany it also impact the conditions in which families raise their children.
We believe that if we improve the conditions our families live in, we can decrease the causes and rates of childhood adversity, trauma and maltreatment.

Our 100% Community course is strongly influenced by our understanding of the social determinants of health and our local innovations are designed to address lack of services for families. Visit our research page to explore more on the social determinants of health.

What is the collective impact model and how does it inform 100% New Mexico initiative?

Katherine Ortega Courtney, PhD responds:

Developers of the Collective Impact model John Kania and Mark Kramer discuss, in the Stanford Social Innovation Review, how large-scale social change requires broad cross-sector coordination and the importance of social sector focusing collaboration instead of the isolated intervention of individual organizations. They describe how successful collective impact initiatives typically have five conditions that together produce true alignment and lead to powerful results.

The first condition, or components, would be a common agenda with shared vision and goals. Our 100% New Mexico initiative requires this first and foremost. We are taking on a huge challenge with a thousand moving parts, so the shared vision holds it all together.

A key component of collective impact is a shared measurement system which guides how data are collected, protected and shared. In our county initiative we start with our parent and youth survey, but many more assessments will follow in order to understand both the challenge ahead and the capacity to solve those challenges on the county level.

Mutually reinforcing activities, which include what our course projects call local innovations, are another vital component of the initiative. Collective impact works because all the activities are connected in some way, as though a county is building a system.

And, of course, that is what the 100% New Mexico initiative is, one system that is made up of at least ten systems that represent our ten surviving and thriving sectors. Put another way, we are one countywide coalition made up of ten coalitions. This is where the cross-sector nature of our initiative is important as what the action team on food discovers might very well impact what the action team on parent supports is working on. With so many participants working in ten action teams across a county, the third component of collective impact comes into play. This is continuous communication using social media and advances in technology.

And of course, any initiative that is going to be long term is going to need backbone support organizations to provide stability, funding and a physical meeting place. 100% Community requires a well-respected and well-run organization to serve as the sponsor.

Our 100% New Mexico initiative is strongly influenced by collective impact. Collective impact is used for systems change as it takes multiple people from multiple organizations coming together to make the kind of changes needed to ensure that 100% of county residents have access to ten vital services.

What is continuous quality improvement (CQI) and how does it guide our work?

Dominic Cappello responds:

CQI is described in more detail in the next online lesson, but for an overview it is helpful to know that the CQI framework exists in a variety of forms to guide projects in both the public and private sectors. For 100% New Mexico initiative we use the following four steps: assess, plan, act and evaluate. Another CQI framework uses the steps of Plan, Do, Study, and Act.

What’s most important to understand about CQI is that it is a data-driven process, one that asks us to carefully design an innovation that is backed by data every step of the way. Each of our four steps comes with a series of questions. These questions are asked in the following four web-based lessons. Your instructor and coaches can help you answer the questions that provide the foundation for your course project.

Our 100% Community course and entire initiative is built around the assess, plan, act, evaluate CQI framework.

What can you tell us about the adaptive leadership model?

Katherine Ortega Courtney, PhD responds:

The Practice of Adaptive Leadership by Heifetz, Grashow and Linsky is a required textbook for many reasons. We are huge fans of the adaptive leadership process, having been introduced to it while working with management in the child welfare system. When we were writing 100% Community, we could just imagine readers getting to the chapter on adaptive leadership and rolling their eyes when being told, “You need to read another book to implement the 100% New Mexico initiative successfully.” The truth is that the book and insights within are invaluable as we work to improve entire county systems. Initiative participants will have lots of technical challenges to address and while these are tough, they are doable.

Technical challenges are things like how to build a school-based health center, as in the actual nuts and bolts and construction issues. The adaptive challenge can be truly difficult and time-consuming. If we stick to the example of a school-based health center, the politics around it can be volatile. Some board members and parents may feel strongly that such an addition to a school is totally unnecessary. Others may suspect that a behavioral health care component to the center might bring up all kinds of issues, especially if ACEs are addressed. On the other side might be those eager to have a school-based wellness center and one stop shop for families, all in a place kids are already at. Bottom line, the adaptive challenge in this instance is listening really all to all voices, especially those who control whether or not a project like a school-based health center moves forward. The book, Adaptive Leadership, prepares us all for push back to change.

What I found very helpful is the authors’ take on change and how it has a lot to do with leaders or power-brokers feeling a sense of loss. I do not enter into any controversial community project without opening up Adaptive Leadership for a refresher on push back to change and getting on the balcony to take an objective look at a project where there may be division. At the beginning of our work in counties we were hitting one adaptive challenge after another. I kept my cool and optimism because of the lessons from Adaptive Leadership’s chapters.

How many frameworks and models guide the 100% New Mexico initiative?

Dominic Cappello responds:

To guide our 100% Community work, there are hundreds of helpful frameworks and models from the fields of public health, education, child welfare, youth development and early childhood education. We have chosen three to start with.

When it comes to developing an innovation, regardless of what the framework is called, you will need the skills of assessing, planning, action and evaluation.

As you develop an innovation, you may find yourself introduced to new models and frameworks. For example, if you were to work in the arena of early childhood education you would be introduced to the Reggio Emilio model, a very well-respected model for designing and implementing a specific type of learning program developed in Italy and used in the US. As you explore different service sectors, we encourage you to share with your program associates all models and the research guiding them. We will add them to our research page for all future 100% Community participants to access.

Is there a model for focusing on the positive, rather than just trying to fix what doesn't work?

Katherine Ortega Courtney, PhD responds:

Yes, there are many models and one we encourage you to explore is called appreciative inquiry. It is often called a strength-based approach and was developed by David Cooperrider at Case Western University and focuses on asking questions in order to foster positive relationships, which lead to envisioning a future that works better for all involved in a project.

The model uses a process that includes: discover, dream, design and destiny. When we looked at the article, “A Positive Revolution in Change: Appreciative Inquiry” by Cooperrider & Whitney, D. (Taos, NM: Corporation for Positive Change, 1999), we saw some summary statements about the model that we found inspiring: “Words create worlds. Inquiry creates change. We can choose what we study. Images inspire action. Positive questions lead to positive change.”

We might not spend a lot of time discussing appreciative inquiry but it’s a helpful model to know about as we move into communities to listen, learn, imagine and collaborate.

What are the goals of the course and benefits to participants and their agency staff?

Dominic Cappello responds:

The goals of the course are increasing participants’ skills in:

Data mining and analysis in order to identify challenges in providing quality services agencies and create ways to address those challenges using a data-informed decision-making process
Journal research and analysis to learn how other states and countries have addressed health and safety challenges
Communicating, facilitating, brainstorming, developing questions, creating an hypothesis, and testing assumptions in order to launch local innovations

The benefits of the course are:

Workforce and community, skilled in using CQI, to strengthen agencies to serve families and children
A community of agency leaders empowered to facilitate change using a collaborative and data-driven process
Improved services for families leading to better health and safety outcomes for children and parents in the community

RETURN

Lesson 1: V

OUR RECIPE

Lesson 1: VII

WHAT’S CQI

March 3 2020

Course – Lesson 1: VII. Frameworks

Institute StaffLesson 1

WHAT'S CQI

CONTINUOUS QUALITY IMPROVEMENT

LESSON 1:VII – Q+A with authors Katherine Ortega Courtney, PhD and Dominic Cappello

What is CQI (Continuous Quality Improvement)?

Katherine Ortega Courtney, PhD responds:

Continuous Quality Improvement (CQI) is the ongoing process of identifying, describing, and analyzing strengths and problems and then testing, implementing, learning from, and revising solutions.

Key actions of the CQI Process

Identify an issue using data or some other reliable source of information.
Research ideas around the reasoning behind that issue and the current level of performance.
Set a time-bound, measurable goal the team wishes to achieve after reviewing the issue.
Develop action steps to address the issue.
Action steps should include the person/people responsible and the target date for completion of the action step.
Track and adjust the action steps to determine if planned interventions are working.
Close the feedback loop by sharing the information learned with others.

Who is involved in Continuous Quality Improvement?

Dominic Cappello responds:

CQI is the framework that will be guiding all action teams in the 100% Community Initiative. Every stakeholder involved in a particular sector should have at least a basic understanding of the CQI framework. With some projects the problem identified may be a lack of quality on the part of a particular agency. If this is the case, the action teams may propose to the agency leadership that CQI may be used to address agency challenges.

What are the key components of the CQI cycle?

Katherine Ortega Courtney, PhD responds:

Assess: Using data, identify improvement opportunities and resources.

Plan: After analyzing data, build a measurable plan.

Act: Implement plan with measurable outcomes.

Evaluate: Monitor progress with all stakeholders.

Why is CQI a team process?

Dominic Cappello responds:

CQI cannot operate in a vacuum. Objectives, goals, and implementation are shared responsibilities and activities. When the team shares an understanding of the process, the team can move forward as one.

When an action team works together, CQI is fully supported.

What is the importance of quality data for CQI?

Katherine Ortega Courtney, PhD responds:

We need quality data that is accurate and timely in order to assess a challenge. Data need to be current and analyzed with care to support the entire CQI process. Our action teams focused on the surviving and thriving services will be in contact with a wide variety of agencies providing specific services. Data will need to guide all attempts at improvement.

What is the possible impact of CQI on a Community and the agencies within it?

Dominic Cappello responds:

Positive Responses

Opens up all aspects of work to possible improvement.
Frees up ways of thinking about work (“we’ve never done it that way before”).
Reframes the idea of failure. Turns it into an experiment.
Makes it a process of discovery and adaptation.
Allows for growth and encourages growth.
Helps to keep priorities upfront.
Can change the culture of the office/organization.
Improves organizational accountability.
Refines service delivery process.
Supports flexibility when meeting service needs change.
Enhances information management, client tracking and documentation.
Lends itself to design of new programs & program components.
Allows creative/innovative solutions.

Negative or Disruptive Responses

People may feel threatened by CQI and use of data to assess their work. People feel a sense of loss as the old way of making decisions (by hunch, or idea of a higher up) is traded in for a data-driven process. See the section on adaptive leadership.

RETURN

Lesson 1: VI

FRAMEWORKS

Lesson 1: VIII

OUR SURVEY

February 28 2020

Course – Lesson 1: II. What are key concepts and terms to explore?

Institute StaffLesson 1

CONCEPTS

Terms to explore

LESSON 1:II – What are key concepts and terms to explore?

INTRODUCTION TO THE PROGRAM

You are at the forefront of a new movement, focused on the data-driven, cross-sector and technology-empowered prevention of childhood trauma and maltreatment. Our work differs from what’s been done for two decades, since the publishing of the Adverse Childhood Experiences (ACEs) Survey by Doctors Felitti and Andor in 1998.

Our approach is systemic and comprehensive, guided by decades of research focused on the social determinants of health, health equity, health and education disparities and historical trauma and resilience. Rather than focusing on how an individual addresses his or her own trauma, we are focused on how an entire county, including all cities, towns and communities within its borders, prevents and treats trauma.

We are not using jargon to make the process of preventing childhood adversity more complicated, instead we are committing to a very specific type of process that is results-focused.

We have worked hard to avoid insider phrases throughout the course, but a few upfront definitions might be helpful to readers not familiar with some terms used within behavioral health care, child welfare and public health.

The 100% New Mexico initiative is at the forefront of the data-driven and cross-sector prevention of adverse childhood experiences, trauma and maltreatment.

For the past decades there have been trainings on trauma and the brain, design of delivery of health care, teaching and program activities that are sensitive to those who have been traumatized, sporadic in-services for health educators, workshops for parents, lessons for students and informational websites offering insights on emotional health and trauma. We applaud this work in generating awareness and offering sensitivity. These strategies, called being “trauma-informed,” is the first step in addressing ACEs. It is not, however, a comprehensive trauma prevention strategy.

While the 100% New Mexico initiative continues to build awareness, it is first and foremost about building the capacity of communities to ensure that ten vital family-focused services exist in order to prevent ACEs, trauma and adversity before they can occur. As stated in Anna, Age Eight, the data-driven work we are proposing is a social moonshot level community project. We are honored to have you along for the ride.

Data-driven

Instead of the method used in some organizations – decisions based on hunches, what’s been done before, or the whim of the director, we base all our work on data. We’re swimming in excellent data and research that provides all the information we need to start solving challenges today. And data are far from only quantitative (intimidating numbers). Data are also qualitative and come from the stories and inspiring life experiences of our friends and neighbors.
Cross-sector

Instead of doing our work in isolation or a silo, we reach across the key sectors of the multi-disciplinary public sector to coordinate work. We’ve identified (described in our textbooks) ten vital services in ten distinct social sectors that make up a resilient family-friendly community. This means child welfare and public health work in synch with education, youth mentor programs, behavioral health care, and early childhood education programs. We communicate across our agencies to assess challenges, plan with research, implement action and measure progress.
Systemic

Instead of looking at only one particular part of the challenge facing families, we approach our work by looking at the health of an entire community system. The magnitude of the problem requires that we take into thoughtful consideration all the interrelationships and interdependencies among the parts of the whole, whether it be our own organization or the communities we focus on. Technology makes systemic work, internally and externally, transparent. For meaningful change, systemic thinking is required.
Data Leaders programs

These are continuous quality improvement programs housed within government agencies like child welfare and non-governmental agencies to train the workforce in using data to identify and solve problems. These programs build collaboration between data specialists, upper management, training staff, and the field workers, in order to improve outcomes for the populations their agencies serve. The design of the 100% New Mexico initiative, in many ways, was informed by the design of the Data Leaders for Child Welfare program sponsored by Casey Family Programs and implemented in New Mexico, New York City and Connecticut.

RETURN

Lesson 1: I

OBJECTIVES

Lesson 1: III

WHY NOW?

February 28 2020

Course – Lesson 1: III. Why are we here?

Institute StaffLesson 1

WHY NOW?

20 YEARS LATER

LESSON 1:III – How we are finally making a difference

Why are we here?

More than twenty years ago the Adverse Childhood Study was published, explaining to the nation that a significant percentage of adults had endured ten adverse childhood experiences, including abuse and neglect. The Study detailed the emotional and physical costs of the experiences and made recommendations to address what some called a public health crisis.

Decades later, we have one in eight children being substantiated as maltreated by child protective services by age 18 and a quarter of the adult population reporting three or more adverse childhood experiences. While we have a child welfare system to intervene in cases of maltreatment, we have yet to create a city, county or state agency with the sole mission of preventing trauma and maltreatment.

Yes, a county may have a coalition here, or a short term funded project there focused on awareness of the problem; however, we (champions in all 3000+ counties across the US) have not invented and institutionalized the prevention of ACEs on the local or state level. We are working toward the day when every city has a “Dept. of Family and Community Resilience” that does the work of a local 100% New Mexico initiative.

You are part of the process and we are grateful you are here.

How can a small group of people make a difference?

First, as you have no doubt read many times, anthropologist Margaret Mead is famous for saying, “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.” We agree 100%.

You, as a 100% New Mexico initiative participant, are part of a grand experiment. Our process is in a state of constant improvement as we seek to provide a learning experience for you and like-minded problem solvers. We are seeking to learn from you, as you move through the course and begin implementation of a local innovations and projects shown to increase access to our ten “surviving” and “thriving” services.

Questions that guided the design of this course

How do we ensure that our local 100% Community co-organizers and action team members have a shared understanding of the twenty key concepts guiding data-driven ACEs prevention?
How do we ensure that our local 100% Community co-organizers and action team members have the support for the development of measurable and meaningful innovations and projects?
How do we ensure that the initiative participants have the time and energy to be sweeping away obstacles and distractions in order to get real work done?
How do we ensure that all action team members have access to the latest research on innovative solutions in our ten services sectors?
How do we know if initiative participants feel supported by technical assistance, using technology to communicate long distance?
How do we support initiative participants and their long-term work, understanding that some innovations might be done in a few months while others could take a few years?

Our process will improve because of course participants’ willingness to communicate about what works, what doesn’t and how can we strengthen the entire process of online and technology-support tele-communication to meet the needs of all initiative participants as the move from assessing challenges and gaps in services to implementing change in the form of a local innovation.

RETURN

Lesson 1: II

CONCEPTS

Lesson 1: IV

ACES SURVEY

February 28 2020

Course – Lesson 1: IV. ACEs Survey

Institute StaffLesson 1

ACES SURVEY

Adverse Childhood Experience Survey

LESSON 1:IV – MEASURING THE MAGNITUDE OF ACES AND TRAUMA

Using the tool with care

What is the magnitude of adverse childhood experiences (ACEs) in your county? The ACEs survey scores are a starting point for discussing the level of ACEs-related childhood trauma and untreated adult trauma in your county. The ACEs Survey was developed and first published in the The Adverse Childhood Experiences (ACE) Study. Felitti et al.1998. (https://aae.how/202)

In Anna, Age Eight we explore the survey, noting how adults respond differently to the results of the ten-question survey. This ranges on a continuum from thinking, “Yeah, my family was tough but I made it through” to those who are aware of their long-term struggles with feelings of trauma associated with childhood abuse and neglect.

The ACEs survey is a powerful tool. It will allow your community and county leaders and stakeholders to understand the magnitude of adverse childhood experiences and potential trauma within the youth and adult populations. The survey process should be used with care. The information it reveals to the survey taker can be a trigger for memories of adversity, abuse and neglect. We recommend that organizations using the survey let respondents know, before taking the survey, where they can access people to talk with (i.e. in a school setting, the school-based behavioral health care center would be such a place).

The role of the survey in 100% Community:

As stated above, your local initiative team will want to reach out to residents working in all 10 sectors to discuss how the ACEs survey might be used with both student and adult populations. Your local public health and child welfare data will provide a lot of information about the scope of trauma in your community.

ADVERSE CHILDHOOD EXPERIENCE SURVEY

ONE: Did a parent or other adult in the household often or very often push, grab, slap or throw something at you? Or ever hit you so hard that you had marks or were injured?

TWO: Did a parent or other adult in the household often or very often swear at you, insult you, put you down or humiliate you? Or act in a way that made you afraid that you might be physically hurt?

THREE: Did an adult or person at least five years older than you ever touch or fondle you or have you touch their body in a sexual way? Or attempt, or actually have, oral, anal or vaginal intercourse with you?

FOUR: Did you often or very often feel that no one in your family loved you or thought you were important or special, or that your family didn’t look out for each other, feel close to each other or support each other?

FIVE: Did you often or very often feel that you didn’t have enough to eat, had to wear dirty clothes or had no one to protect you? Or your parents were too drunk or high to take care of you or take you to the doctor if you needed to go?

SIX: Did you live with anyone who was a problem drinker or alcoholic? Or who used street drugs?

SEVEN: Was your parent or stepparent often or very often pushed, grabbed, slapped or hit by a thrown object? Or sometimes, often, or very often, kicked, bitten, hit with a fist or hit with something hard? Or ever repeatedly hit for at least a few minutes or threatened with a gun or knife?

EIGHT: Was a household member depressed or mentally ill? Or did a household member attempt suicide?

NINE: Were your parents separated or divorced?

TEN: Did a household member go to prison?

Review the interactive Adverse Childhood Experiences survey below to understand what it can reveal to people of all ages. The ACEs survey is not provided here to serve as a diagnostic tool. It is provided to promote awareness of ACEs and encourage dialogue about the impact of adversity and potential trauma.

Click to explore our interactive ACEs survey

It is important to note that the ten questions above are the original ten that were asked in the first study. In recent years, tools have been developed that include other questions broadening the scope of Adverse Childhood Experiences to include experiences such as discrimination and parental separation. ACEs should be considered a starting point for measuring trauma, rather than a comprehensive list of all traumatic events that may happen in childhood.

RETURN

Lesson 1: III

WHY NOW?

Lesson 1: V

OUR RECIPE

February 28 2020

Course – Lesson 1: Engage

Institute StaffLesson 1

ENGAGE

ENGAGE WITH THE COMMUNITY

LESSON 1:I – What are the learning objectives of this lesson?

What are we learning?

In this session, we review the key concepts that guide our 100% New Mexico initiative. We will reinforce the goals and components of the county initiative — a program designed to strengthen a collaborative and data-driven process of capacity-building.

The ultimate goal of the initiative is to prevent adverse childhood experiences (ACEs), childhood trauma, social adversity and maltreatment that sends families into the child welfare systems. We seek to improve health and safety outcomes for the children, youth, families and communities we serve.

Our hypothesis: If we provide to families ten vital services for surviving and thriving, we can increase family and community resilience factors and decrease childhood adversity, trauma and maltreatment. The course supports an analysis of the community “systems of safety and care” to provide insights into problems and solutions.

Participants completing the online course will be able to:

Navigate the 100% Community course website to access lesson objectives, lessons and links to resources, data and research.
Describe the key points of the course text books Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment and 100% Community: Ensuring trauma-free and thriving children, students and families, including the root causes, cost and consequences of adverse childhood experiences, trauma and social adversity.
Describe the concepts and frameworks used to understand challenges and design solutions including: the social determinants of health, collective impact and continuous quality improvement.
Describe the social determinants of health, why they guide the 100% New Mexico initiative, and the ten vital family services/programs shown to create resilient childhoods and strengthen families.
Demonstrate how to communicate effectively about the course and initiative and local projects the team are developing.