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Turn ACEs and PCEs Data Into Action
To build a comprehensive ACEs and PCEs data collection and monitoring system, you’ll need to balance the strengths and weaknesses of individual data sources by gathering information from multiple sources, triangulating the data, and turning it into data-driven ACEs prevention and intervention actions.
You will take multiple steps to go from data to action. Let’s walk through them one at a time.
Assessing Data Sources and Selecting Data
You won’t be able to collect all data from every data source, so you should consider the strengths and limitations of the sources available to you. And you should use multiple methods and sources for data collection of ACEs and PCEs to do the following:
- Identify specific trends in ACEs and PCEs among children and adolescents.
- Identify specific populations to focus your prevention, intervention, and response efforts. This could include specific demographic groups or geographic areas.
- Identify and measure specific risk and protective factors related to reductions in ACEs. This can also include measuring PCEs.
A circular flow diagram with four connected steps:
- "Assess multiple data sources and select data" (purple circle)
- "Triangulate data from different sources to understand the situation" (gray circle)
- "Develop and implement a data-backed prevention plan" (gray circle)
- "Identify and address gaps before the next cycle" (gray circle)
The circles are connected by light blue arrows showing the cyclical flow from step 1 to 2 to 3 to 4 and back to 1.
Download this checklist to help you assess multiple data sources, data elements, and other considerations.
It is also important to consider what prevention activities you are implementing, and whether there are data elements that would be reasonably impacted by these. For example, if your prevention activities are related to strengthening economic support to families and the earned income tax credit, do you have data being collected about economic circumstances for families?
Consider how to collect data through your data collection systems that will align with and show the impact your prevention strategies are making. It is important to remember that many ACEs risk and protective factors are universal: that is, they may place children at disproportionate risk—or benefit—regardless of where a child might reside geographically within a state, territory, or tribe.
However, by understanding community-specific differences in risks or needs, you can address those more acutely with tailored and effective prevention and intervention strategies.
It might help to think of the different levels of data as an information waterfall.
The Information Waterfall
National Level Data Collection Questions
What are the broad trends in ACEs data that may present a starting point for learning more?
State, Territory, Tribe, or Jurisdiction Level data collection questions
What is the baseline estimate of ACEs currently experienced in this state, territory, tribe, or jurisdiction?
What individual ACEs are most commonly experienced in this state, territory, tribe, or jurisdiction?
What demographic subpopulations are most disproportionately impacted by ACEs in this state, territory, tribe, or jurisdiction?
Local or Community Level data collection questions
What is the scope of the broader problem with a specific community?
Where and when do ACEs most likely occur and who is at greatest risk here in this specific community?
What health and societal circumstances and impacts are unique to this specific community?
Impact Level Implementation Question
What tailored and relevant prevention or intervention strategies can we recommend and feasibly implement?
Triangulating Data Sources
Triangulating data means integrating information you have learned from one data source with data from other sources in order to create a comprehensive illustration of ACEs and PCEs, risk and protective factors, and help you select and evaluate possible prevention strategies.
For instance, youth-based data, or data collected among youth, often only provides information at the state level (for example, via the Youth Risk Behavior Surveillance System, or YRBSS), though sometimes information is available for specific tribes, regions, or localities. However, information from the state-wide system can provide baseline information about who is experiencing more ACEs. These data can also tell us what kinds of ACEs are the most common – and among whom. When triangulated with data collected at the community-level, state-level data may help you create a clearer and critical picture of ACEs both within the state and within a community.
Administrative data has limitations, because it often only represents a small proportion of an overall problem. This is particularly true for examining ACEs and PCEs. However, when triangulated with other types of data, it can powerfully improve our understanding.
Consider the hypothetical example below. Without triangulating data from all three sources (the National Syndromic Surveillance System (NSSP), YRBSS, and a SDOH data source), we might miss a critical intersection. Always seek the most holistic data picture.
EXAMPLE:
Click on each circle to discover the critical intersection.
Learn MoreIn this module, you’ll explore the importance of a data collection and monitoring approach that is comprehensive and integrated.
Developing an Action Plan
Once you’ve triangulated your data, you’ll be better able to develop prevention and intervention strategies that will be most appropriate and impactful as you continue monitoring ACEs and PCEs. That way, you’ll have ongoing baseline comparisons ready to compare over time.
Reduced rates of ACEs may not be seen in the data for several years after a prevention measure or intervention is implemented, and that’s why continued data collection and monitoring is so important. Consider this real-world example of actions that were inspired by data and led to real results.
2X
ABUSIVE
PUNISHMENT
in single-parent households
vs two-parent households
Data
A 1985 retrospective survey of 802 adults found that abusive punishment in single-parent households is two times higher than in two-parent households. While we now know about contributing and exacerbating factors of reduced social support, such as increased stress and fewer financial resources, this was an important ACEs related indicator for parental abuse (before the term ACEs was coined). When scientists uncover risk factors for ACEs, like in this study, it emphasizes the importance of identifying and evaluating evidence-based prevention programs to reduce those risk factors. This includes, for example, a 1988 randomized trial of a nurse home visitation program.
Action
The Nurse-Family Partnership (NFP) pairs registered nurses with low-income, first-time mothers during pregnancy and continues through the child’s first two years of life. Nurses provide home visits, education, and support to promote healthy prenatal care, child development, and positive parenting practices.
UP TO50%
Reductions in Child Abuse,
Neglect, and/or Injuries
Positive Health Outcomes
Follow-up studies, backed by continued ACEs data collection and monitoring, show NFP leads to improved health outcomes, reduced child abuse and neglect, and improved school readiness, specifically: 20-50% reductions in child abuse, neglect, and injuries.
Download this Action Plan Template to get started.
Identifying and Addressing Gaps
Even after you have started honing your prevention strategies based on the available data, there is always room to continue identifying gaps in the data you have already included and continue making improvements.
The process of building a comprehensive ACEs and PCEs data collection and monitoring system is iterative. Consider adding and removing data sources from your system until you have sufficiently addressed your primary questions that help you identify, monitor, and hone prevention strategies for ACEs at the state, territorial, tribal, and community level. For more information about evidence-based prevention strategies for ACEs you could implement in your community, please read CDC’s ACEs Prevention Resource for Action.
A circular flow diagram with four connected steps:
- "Assess multiple data sources and select data" (purple circle)
- "Triangulate data from different sources to understand the situation" (gray circle)
- "Develop and implement a data-backed prevention plan" (gray circle)
- "Identify and address gaps before the next cycle" (gray circle)
The circles are connected by light blue arrows showing the cyclical flow from step 1 to 2 to 3 to 4 and back to 1.
In addition to building your ACEs and PCEs data collection and monitoring system system, you can also use the data to evaluate the effectiveness of your prevention and intervention efforts. Ask yourself these questions to help you identify and address gaps:
- What data would you still need to address your public health question of interest?
- Do you need more data on a certain population, or a specific ACEs indicator?
It’s okay if you do not have access to all the ACEs and PCEs data you need right away. Start with what you have, what is most useful for your public health practice goals, and continue to improve your ACEs and PCEs data systems as you are able.
Data to Action: Next Steps
You’ve reached the end of the ACEs & PCEs Data to Action Learning Hub—but this is just the beginning. With new knowledge about data collection, monitoring, and turning information into action, you’re ready to take the next step.
Head to the Resources Page to keep learning and start putting your knowledge into practice today.
Ready to put your learning to action? Access Resources