Preventing Adverse Childhood Events through Community Interventions with Emergency Medical Services (PACE) - Problem: Adverse Childhood Experiences or ACEs are traumatic events occurring in childhood with negative, lasting effects on health, wellbeing, and opportunity. Social determinants of health such as economic stability, quality health care access, and physical living conditions impact health outcomes for children. Child abuse and neglect, a serious cause of morbidity and mortality among children, is an ACE of particular concern strongly correlated to poverty, housing instability, food insecurity, and uninsurance. Emergency Medical Services (EMS) sits at the intersection of public health, public safety, and healthcare. Neighborhoods with high EMS utilization have higher rates of Child Protective Services reports and EMS may be well situated to identify at-risk families who may benefit from community support program (CSP) services. Objectives: The goal of the PACE Project is to create an ACE risk detection tool through combination of existing datasets with novel geospatial and healthcare data to identify at-risk families and expand ACE prevention strategies through an EMS-CSP partnership. These activities will enhance the current state ACE surveillance in 2 states and instill a novel pathway for referral of families to support services, mitigating inequities in social determinants of health, and creating new partnerships with the public safety and public health sector. The PACE Project Team intends to accomplish the following three goals: Goal 1: Build integrated geospatial ACE surveillance system using existing federal, state, regional and local SDoH resources (PACE Geospatial Information System [PACE-GIS]); Goal 2: Implement and sustain ACE prevention strategies through a novel referral pathway for families with service needs using EMS and CSPs (PACE Pathway); Goal 3: Connect families identified through expanded surveillance to CSPs through the PACE Pathway implementation and dissemination (PACE Data to Action). Coordination: The project principal investigators have existing multi-sectoral partnerships with surveillance entities and CSPs providing ACE prevention services. Anticipated Products: This proposal includes a variety of projects. First, we will create and disseminate state-specific databases from geospatially linked data for SDoH from multiple resources (PACE-GIS) for statewide ACE and PCE surveillance. Second, we will create, pilot, and disseminate a household-level screening tool (PACE-HST) for implementation in local settings. Third, scholarly articles and scientific presentations will be created to disseminate findings to policy and research audiences. Fourth, policy briefs and infographics will be provided to policymakers and practitioners. Finally, a comprehensive toolkit (PACE Toolkit) will be created to disseminate the full PACE model to other locations. Evaluation: The PACE Project Team will conduct longitudinal assessments using the Developmental Evaluation approach to assess the reach and degree of success of family engagement with support services. The team will further analyze ACE prevention and PCE promotion outcomes through surveys and interviews.
