OBJECTIVES: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic. METHODS: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as a barrier to accessing services (N = 49 817). We used joinpoint regressions to examine whether the rate of change differed significantly from 2016-2019 (before the pandemic) to 2019-2021 (during the pandemic). RESULTS: The number of immigrant contacts to NDVH peaked in 2017 (n = 9333) and declined 25% to 6946 in 2021. During 2016-2019, the percentage of contacts reporting the following increased significantly: technology-facilitated violence (+12.7 percentage points), economic/financial abuse (+10.8 percentage points), and involvement of firearms (+4.8 percentage points); during 2019-2021, these trends reversed. The percentage of contacts reporting separation or divorce was relatively flat until 2019 and then increased from 14.6% in 2019 to 19.9% in 2021 (+5.2 percentage points). Housing instability increased during 2017-2020 (+9.3 percentage points), but requests for shelters decreased (-4.5 percentage points). Immigration status and personal finances were commonly reported barriers to services; both decreased during 2016-2019 but then increased during 2019-2021. CONCLUSIONS: This study can inform prevention and response strategies relevant for immigrants experiencing or reporting IPV.

There is increasing scientific evidence linking substance use, childhood adversity, and social determinants of health. However, little research has considered the evaluation of community-level strategies to reduce substance use by increasing awareness and implementation of evidence-based strategies for preventing adverse childhood experiences (ACEs). This article lays out the conceptual framework for a $2.9 million demonstration project designed to raise awareness of the impact of ACEs on substance use, including primary prevention strategies. Communities used transformational narrative change-with an emphasis on the voices of those most impacted by ACEs and substance use-to highlight the importance of addressing social determinants of health along with primary prevention strategies. The conceptual background highlighted in this article informed media, public health, and local efforts in the three accompanying articles and invited commentary. These findings may help inform future efforts to promote community-level strategies and strengthen the evidence-base for transformational narrative change efforts.

Adverse childhood experiences (ACEs) are potentially traumatic but preventable experiences that occur before the ages of 18, including child abuse, witnessing violence, and parental substance use. ACEs have been linked with increased risk for substance use, along with a variety of other negative health outcomes. However, there is limited evidence of community-level strategies that link ACEs and substance to increase awareness of prevention efforts. This article reports on a $2.9 million program to promote health equity and inform narratives for the prevention of ACEs and substance use within three Midwestern communities. Program partners sought to create new transformational narratives that linked ACEs and substance use, while underscoring the importance of addressing social determinants of health (SDOH) that lead to disparities in ACEs and substance use. A mixed-methods evaluation design included document review, in-depth interviews with program staff (N = 8) and community liaisons (N = 2), and site reports from program staff (N = 8) and their community partners (N = 17). Analyses showed that successful implementation efforts had early leadership buy-in and support, set clear and manageable expectations at the outset of implementation, and developed strong relationships with organizations that engage in health equity work. Training and technical assistance were critical to helping community partners build trust, recognize each other's perspectives, broaden and reframe their world view, and better understand narrative efforts for the primary prevention of ACEs and substance use.

Local media narratives play an important role in how people interpret and propose solutions for health issues in their community. This research characterized narratives about adverse childhood experiences (ACEs), and/or social determinants of health (SDOH) in media coverage of substance use. Scans covered articles published in the Detroit Free Press and the Cincinnati Enquirer from March 1, 2019 to June 1, 2019 and March 1, 2021 to June 1, 2021. Scans used search terms for opioids and substance use. Included articles were coded and analyzed for narratives about why people use substances, how to prevent substance use, and how ACEs or SDOH relate to substance use. While half of the included articles reported on the overdose epidemic, the most common type of media coverage reported on criminal justice milestones. Other common narratives identified addiction as an illness that should be treated; and over-prescription of painkillers or the strength of the drugs as causes of substance use disorders. Narratives about SDOH and the primary prevention of ACEs and substance use were limited. Transformational narrative change work can increase support for addressing the root causes of ACEs and substance use. Results suggest this strategy remains largely untapped in the formal media.

OBJECTIVE: Adverse childhood experiences (ACEs) are associated with increased risk of sustaining a traumatic brain injury (TBI). Alcohol use may play an important role in this relationship. This study examines whether binge drinking mediates the relationship between four ACEs and TBIs sustained in adulthood. METHODS: Using the National Longitudinal Survey of Youth, 1979 cohort, we conducted longitudinal mediation analyses (n=6317). Interviews occurred annually from 1979 to 1994 and biennially until 2016. We evaluated the direct and indirect effects of individual ACEs (ie, experiencing physical violence, low parental warmth, familial alcoholism and familial mental illness; reported retrospectively) and a cumulative ACEs score on mean level of binge drinking (calculated across waves) and having a TBI in adulthood. To establish temporality, we included binge drinking that was measured at age 18 or older and before any reported TBI. RESULTS: Cumulative ACEs, familial alcoholism and physical abuse exposure were significantly associated with having a TBI through binge drinking, although this only explained a small part of the association between ACEs and TBI. Other ACEs were not significantly associated with binge drinking or TBI. CONCLUSION: The results indicate that while ACEs and adult TBI risk were significantly associated, lifetime binge drinking explains only a small part of the association. Future research could examine alternative social, biological and behavioural mechanisms along the pathway between ACEs and TBI. Determining this mechanism will allow public health practitioners to design and implement effective TBI prevention programmes for those at higher risk of injury due to ACE exposure.

Male romantic jealousy is a commonly cited driver of intimate partner violence (IPV) against women. An in-depth, contextualised understanding of the pathways and mechanisms from jealousy to intimate partner violence is however needed to inform programmes and interventions. We triangulated data from 48 interviews, eight focus groups and 1216 survey findings from low-income married women and men in northern Ecuador. Male jealousy was associated with controlling behaviours (aOR: 14.47, 95% CI: 9.47, 22.12) and sexual intimate partner violence (aOR: 2.4, 95% CI: 1.12, 5.12). Controlling behaviours were associated with physical and sexual intimate partner violence (aOR: 2.16, 95% CI: 1.21, 3.84). Qualitatively we found that most respondents framed jealousy within a discourse of love, and three triggers of male jealousy leading to intimate partner violence were identified: (1) community gossip, which acted as a mechanism of community control over women's movements and sexuality; (2) women joining the labour force, which was quantitatively associated with intimate partner violence and partially mediated by jealousy; and (3) women's refusal to have sex, which could lead husbands to coerce sex through accusations of infidelity. Gender-transformative interventions at the individual, couple and community level providing models of alternative masculinities and femininities may offer promise in reducing intimate partner violence in Ecuador. Importantly, future economic empowerment interventions should address jealousy to mitigate potential intimate partner violence backlash.

The opioid crisis is a significant challenge for health and human service systems that serve children, youth, and families across the United States. Between 2000 and 2017, the number of foster care entries, a type of adverse childhood experience (ACE), attributable to parental drug use increased by 147%. Nevertheless, there is variation in the burden of opioid overdose and foster care rates across the U.S., suggesting community supports and systems to support families affected by substance use also vary. This qualitative study sampled communities experiencing high and low rates of overdose mortality and foster care entries (i.e., a qualitative comparison group) to better understand what might protect some counties from high overdose mortality and foster care entries. The sample included six counties from three states that were selected based on their rates of opioid overdose mortality and foster care entries. Using purposive sampling within counties, interview and discussion group participants included multi-sector community partners, parents whose children had been removed due to parental substance use, and caregivers caring for children who had been removed from their homes. Across all counties, prevention was not front-of-mind. Yet, participants from communities experiencing high rates of overdose mortality and foster care entries identified several factors that might help lessen exposure to substance use and ACEs including more community-based prevention services for children and youth. Both parents and caregivers across all communities also described the need for additional supports and services. Participants also described the impact of COVID-19 on services, including greater utilization of mental health and substance use treatment services and the challenges with engaging children and youth on virtual platforms. The implications for prevention are discussed, including the need to encourage primary prevention programs in communities.

Purpose: Despite evidence showing the importance of structural determinants for child well-being and the existence of policies that can promote child well-being, many communities are not adopting these policies. Limited awareness of structural determinants may explain this gap. This study establishes the public's recognition of structural determinants and their associations with support for policies that promote child well-being. Methods: Secondary analyses of survey data collected in 2019 from a random sample of 2496 adults in the United States. This survey asked why some children “struggle” (e.g., do poorly in school, use drugs, or get involved in crime). Respondents could select individual (e.g., lack of effort) and structural (e.g., low wages) explanations. Respondents were also asked about their support for policies that are supportive of children and families. Results: Stronger beliefs of structural explanations were associated with greater support for policies that strengthen family economics, family-friendly work, and afford access to high-quality early childcare and education. Beliefs in individual explanations were inversely associated with support for these policies. Conclusions: These findings suggest increasing recognition of the structural determinants that hinder child development may help increase support for policies that are effective in improving children's outcomes. © 2021 Society for the Psychological Study of Social Issues. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Importance: Adverse Childhood Experiences (ACEs) are prevalent, preventable, and a public health issue that cycles from one generation to the next with serious implications for health and wellbeing, particularly. Research is needed to identify factors, including those related to economic position (i.e., wage, net family wealth, home ownership), that break the cycle of ACEs and inform decisions about policies, practices, and programs. Objective: To determine whether economic position moderates the association between mother's ACE score and child's ACE score and whether these pathways differ by race and ethnicity. Design: Conducted regression and moderation analysis using mother-child dyadic data from panel surveys, stratified by race. The simple slopes for the interactions were probed to determine the magnitude and significance of the interaction. Setting: Secondary data analysis utilizing data from two cohorts of the National Longitudinal Surveys: 1) National Longitudinal Survey of Youth 1979; and 2) National Longitudinal Survey of Youth 1979 Children and Young Adults. Participants: The sample included 6,261 children and 2,967 matched mothers. Main Outcomes (s) and Measure(s): The outcome variable was the child's ACE score. Mother's ACE score was the independent variable. Three economic position moderators were examined: mother's and her spouse's average wage and salary, average net family wealth, and percent of time owning a home during her child's first five years of life. Results: Mother's ACE score was positively associated with her child's ACE score. Economic position was a significant moderator for Black families. Higher wages and net family wealth during children's first five years were associated with weakened associations between mother and child ACEs for Black families. For Hispanic families, higher wages and salary were significantly associated with weakened associations. Among White families, higher net family wealth was associated with stronger ACEs transmission. Conclusions and Relevance: Taken together, these findings highlight the important role that economic position may play on breaking the cycle of ACEs. This information can inform decisions about what public assistance policies, practices, and programs may be used to improve economic stability among families as an effective ACEs prevention strategy, and for whom these strategies might be most effective at reducing the cycle of ACEs. © 2021