Research documents the concerning rates and negative outcomes of adverse childhood experiences (ACEs). To date, we know very little about two-generation programs that may simultaneously prevent ACEs among children including intimate partner violence (IPV) among their caregivers. The proposed project addresses objective 3 of NICIPC?s initiative, evaluation of strategies that incorporate a dual generation approach to break the cycle of violence and adversity. The project purpose is to test the impact of a widely researched alcohol and drug abuse prevention program, the Strengthening Families Program (SFP), on reducing ACEs in children (10-14) including child abuse and IPV among their caregivers (primary outcomes). Guided by social learning and ecological theories that empathize the importance of the proximal family environment, the members of this multi-stakeholder collaborative believe that the SFP has the strong potential to be effective in reducing IPV in caregivers and additional ACEs in their children given that the SFP focuses on reducing myriad risk and protective factors for not only drug use, but for ACEs, including IPV and child abuse. As part of this project and in order to bolster the program?s effectiveness, we will adapt the SFP (renamed for this project: Was?ake Tiwahe, Lakota for ?strong families?) to include additional evidence-based IPV prevention strategies (e.g., economic empowerment) for adults and peer-to-peer violence prevention strategies (e.g., bystander intervention) for youth in addition to cultural adaptations given the large presence of American Indians in Rapid City, SD, where this project will take place. During the Adaptation and Planning Phase (Year 1), first the team will convene a Research and Practice Advisory Board and conduct focus groups to adapt the program. Next, the team will conduct an open pilot trial of the adapted program and engage youth and caretakers in cognitive testing of survey instruments to be used in the subsequent clinical trial. During the Outcome and Process Evaluation Phase (Years 2 and 3), the team will implement and evaluate the feasibly and acceptably of the Was?ake Tiwahe via program observations and fidelity checks, key informant interviews, and Photovoice. In addition to the in-depth process evaluation, the team will gather efficacy data by randomly assigning higher risk families, i.e., American Indian and/or low income (N=320 enrolled and randomized), to a wait-list control or treatment conditions. Pre-, immediate post-, and 8-month follow-up surveys will test for reductions in ACEs in youth (N=320), including reductions in IPV in their caregivers (N=320). With exploratory analyses, the team will identify mediators (e.g., increases in adult supervision, economic empowerment) and moderators (e.g., gender) of program outcomes. Finally, during the Revision and Dissemination Phase (Year 3), the team will use data collected in prior phases to revise the program. The revised program adaptation will be appropriate for widespread dissemination to other diverse communities, and the team will share findings and the program with varied audiences (e.g., researchers, practitioners, policymakers, interested citizens).

Public Health Relevance

Although research continues to document the concerning rates and deleterious consequences of adverse childhood experiences (ACEs), we know very little about how to concurrently prevent multiple ACEs in children, including IPV in caregivers and child abuse. The purpose of the proposed project is to test an adapted version of a widely researched two-generation alcohol and drug abuse prevention program?the Strengthening Families Program (renamed for the current project: Was?ake Tiwahe, Lakota for ?strong families?) on reducing IPV in caregivers and other ACEs in their children. The proposal is consistent with the CDC?s priority to identify effective solutions to prevent ACEs as well as the objectives of the Healthy People 2020 to improve the overall health and wellbeing of children and adolescents with a specific emphasis on the critical role of families and caregivers.

National Institute of Health (NIH)
National Center for Injury Prevention and Control (NCIPC)
Research Project (R01)
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Special Emphasis Panel (ZCE1)
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University of Nebraska Lincoln
United States
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