First Americans experience greater levels of inequity than other groups in the United States, including a higher burden of Adverse Childhood Experiences (ACEs). Oklahoma’s ranking as the country’s ninth highest state for youth ACEs exposure puts children in the Chickasaw Nation (CN) at an even greater disadvantage. The key surveillance measure for understanding both ACEs and Positive Childhood Experiences (PCEs) is the Youth Risk Behavior Survey (YRBS), but data from this survey cannot be provided at the necessary levels of granularity to support tribal data to action public health efforts for ACEs prevention.
The proposed project will leverage collaborative, epidemiological and community action successes of the CN Division of Research and Public Health (DRPH) to better understand and prevent ACEs, increase PCEs and reduce health inequities at the population level in the CN. Through collaboration with the Oklahoma State Department of Health (OSDH) and others, this project will inform tribal and statewide efforts for culturally tailored, locally relevant and longitudinally measured ACEs prevention. Active engagement of partners and resources will optimize project impact for a sustainable ACEs and PCEs surveillance and action infrastructure.
The project will successfully achieve the following short-term and intermediate outcomes:
• Increased longitudinal surveillance capacity for ACEs, PCEs and Social Determinants of Health (SDOH) data, including on the Youth Risk Behavior Survey (YRBS)
• Increased access to ACEs, PCEs, risk and protective factors and SDOH data to inform prevention strategies, identify inequities, increase partner and community capacity for data use and evaluate prevention strategy effectiveness
• Increased coordination and collaboration between state, tribal and other agencies and sectors through operation of an ACEs and PCEs Taskforce (APT) and action plan use
• Increased capacity to implement comprehensive ACEs prevention strategies at the tribal and state levels using data to action approaches in multi-sector partnerships
• Increased knowledge about ACEs prevention effectiveness through meaningful use of process and outcome evaluation activities
• Increased tribal and state-level monitoring of trends in ACEs and PCEs over time and SDOH data among the youth population, particularly for First Americans
• Increased uptake, use and reach of comprehensive ACEs prevention strategies, particularly with communities with disproportionate burdens, through partnerships
• Increased evidence for population-based approaches to prevent ACEs
• Increased translation and use of surveillance and evaluation data for tailored prevention strategies through communications approaches, the APT and capacity development for data to action approaches to reduce ACEs and improve health equity and SDOH
• Increased partner response at tribal, state and public levels for addressing ACEs and PCEs in order to facilitate increased safe, stable and nurturing relationships and environments