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Mobilizing Action for Resilient Communities through Policy and Advocacy A TOOLKIT FOR TRAUMA INFORMED CROSS SECTOR NETWORKS

Mobilizing Action for Resilient Communities through Policy and Advocacy A TOOLKIT FOR TRAUMA INFORMED CROSS SECTOR NETWORKS

About the toolkit This toolkit was inspired by the passion and resourcefulness of network leaders we met through the Mobilizing Action for Resilient Communities MARC initiative Partnering across sectors to leverage the science of adverse childhood experiences trauma and resilience these leaders have honed their collective ability to utilize a wide array of tools including advocacy and policy change in order to create the space in their community for transformation If you re reading this toolkit you might be a leader yourself working alongside others as part of a network coalition or other collective to make your community a place where all can and do thrive Our intention with this resource is to encourage the understanding that policy and advocacy are critical and necessary for achieving these network goals We aim to broaden the realm of possibility in regards to the policy solutions we seek and the network roles we undertake to achieve them On the pages that follow look for these icons to Find more information on the underlined topic in our Additional Resources section S hare a response by emailing MARC at MARC HealthFederation org For additional tools and inspiration to unlock the power of networks visit MARC HealthFederation org Acknowledgements We extend our special thanks to the following for their contributions to this toolkit Ruben Cantu Laura Norton Cruz Jonathan Purtle Kathryn Evans Madden Daniel Press Vaishnavi Vaidya Maggie Litgen Elizabeth Prewitt We would also like to thank the Robert Wood Johnson Foundation The California Endowment ACEs Connection and the Campaign for Trauma Informed Policy and Practice Support for this toolkit was provided by the Robert Wood Johnson Foundation The views expressed here do not necessarily reflect the views of the Foundation 3

Introduction Adverse childhood experiences ACEs and trauma are undeniably complex and extremely prevalent problems In any community they can negatively affect the health and well being of individuals across the lifespan their families and even future generations In some communities inequitable social conditions contribute to the accumulation of disadvantage and result in disproportionately high exposure to early childhood adversities McEwen McEwen 2017 No one organization or sector is powerful enough alone to prevent ACEs and trauma or mitigate their impact Together however we can mobilize action for resilient communities See Additional Resources Over the last decade thousands of individuals in hundreds of communities have been doing just that by forming cross sector networks organized around the powerful ACEs Connection Prevention Institute science of ACEs and trauma referred to hereafter as networks Momentum continues to grow as networks take shape at all levels towns cities regions and states across the country and beyond What they have in common is a collective vision to create healthier and more equitable communities by building resilience This toolkit was written by networks for networks to make that vision a reality by building capacity to take an active role in informing policy ADVERSE CHILDHOOD EXPERIENCES ACES Potentially traumatic events occurring before age 18 that can have negative lasting effects on health and well being Felitti et al 1998 NETWORK In this toolkit network refers to a group of residents and organizations or entities representing diverse perspectives across neighborhoods and sectors in a geographically defined community that are leveraging the science of ACEs and trauma to build relationships convene regularly and advance a common agenda around resilience RESILIENCE We define resilience as the capacity to bounce forward from adversity This is not the same as bouncing back to baseline nor is it limited to individuals For example at the systems level bouncing forward looks like identifying and taking subsequent steps to eliminate structural injustice such as racist sentencing practices that disproportionately send people of color to jail Nellis 2016 and thus increase ACE scores for their children At the community level it looks like creating the conditions that will help provide the necessary safety and support when adversity does strike such as access to paid sick leave 4

Why policy and advocacy Policy and advocacy are critical tools for building resilience In public health for example policy change was vital in each of the 10 great achievements of the 20th century Brownson Chriqui Stamatakis 2009 Currently a host of policies at the federal state and local levels needs to change to reflect what science has taught us about the causes and effects of childhood adult intergenerational and community trauma Achieving policy change of this significance and magnitude however requires multiple strategies At a minimum there is the need to educate See Additional Resources elected officials about ACEs science trauma informed programs and legislative or Prevention Institute regulatory changes required to make public policy more supportive There is also the Building Community critical need to connect the dots for them between ACEs and adverse community Resilience experiences Pinderhughes Davis Williams 2015 and increasingly adverse climate experiences Stevens 2017 in order to create urgency and accountability for prevention focused public policies targeting the social determinants of health and health equity Having an impact in the public policy arena requires a long term effort that is unlikely to produce quick dramatic accomplishments Each step forward builds on the ones before it making progress toward the full integration of trauma informed principles SOURCES OF NETWORK CREDIBILITY AND POWER into the policies and practices of government across health education housing There is still truth in the justice child welfare and other sectors see e g Bowen Murshid 2016 adage All politics is local Networks have influence Networks such as those participating in Mobilizing Action for Resilient Communities MARC have tremendous potential to both amplify and accelerate this progress while also providing the resources necessary to sustain efforts over the long term with policymakers and staff in part because their members are local experts represent many sectors institutions and neighborhoods and vote POLICY The term policy is broad and comes in various shapes and sizes In this toolkit we are primarily concerned with public or Big P policy Big P policies include formal laws rules and regulations enacted by elected officials Little p policies govern organizational practices and include guidelines internal agency memoranda and social norms Brownson Chriqui Stamatakis 2009 Although little p policies do not affect the public as a whole they can have a significant cumulative impact Schmid Pratt Howze 1995 ADVOCACY Any action that speaks in favor of recommends argues for a cause supports or defends or pleads on behalf of others It includes public education regulatory work litigation work before administrative bodies lobbying voter registration voter education and more While all lobbying is advocacy not all advocacy is lobbying Alliance for Justice 2018 ADVERSE COMMUNITY EXPERIENCES Beyond the household these are aspects of the socio cultural physical built and economic environments that contribute to toxic stress Pinderhughes Davis Williams 2015 5

What counts as trauma related policy The work of Jonathan Purtle assistant professor at Drexel University s Dornsife School of Public Health provides a useful framework for conceptualizing the broad range of public policy issues that are related to trauma His typology comprises three policy categories all of which are important for creating resilient communities Networks should consider all three types as they develop and implement policy agendas TRAUMA PREVENTIVE Trauma preventive policies help reduce exposure to trauma and create the conditions for safe stable nurturing relationships and environments These policies rarely use the language of trauma and resilience but are vital to the overall goal of creating healthy equitable communities Examples include helping parents and caregivers meet the basic needs of children through family friendly work policies such as livable wages and paid leave Fortson Klevens Merrick Gilbert Alexander 2016 and preventing gun violence through sensible polices that reduce easy access to dangerous weapons such as instituting waiting periods and banning high capacity magazines and bump stocks Prevention Institute 2018 TRAUMA INFORMED Trauma informed policies are designed to raise awareness about trauma both primary and secondary and promote trauma informed practice These policies typically apply to the workforce Examples include regulations that require agencies to provide trauma informed staff trainings in order to receive funding TRAUMA SPECIFIC Trauma specific policies increase access to interventions and services that mitigate the impact of trauma and promote healing These policies typically apply to providers and directly benefit individuals who have experienced trauma Examples include Medicaid reimbursement for trauma focused treatments 6

TYPOLOGY OF TRAUMA RELATED POLICIES Based on the research of Jonathan Purtle DrPH MPH MSc Assistant Professor Dornsife School of Public Health Drexel University It has been said that one good idea can solve many problems Embracing a broader perspective of what counts as potential public policy solutions to address and prevent trauma increases the possibility for alignment and partnership Advocating for policies across Purtle s framework will provide the opportunity for different often new or unconventional allies even if the relationship is short term Note that selecting policy priorities for advocacy efforts can be a challenging task for networks that inherently have diverse membership Consider developing guidelines to facilitate the decision making processes used to identify and select policy priorities The following table lists criteria created by members of the Alaska Resilience Initiative s policy committee that together comprise a voting tool used to score policies under consideration for network action 7

ALASKA RESILIENCE INITIATIVE ARI POLICY DECISION MATRIX The following criteria are considered by members of ARI s policy committee when voting on network policy priorities 1 ADVOCACY Alignment Fits within ARI s long and short term goals Aligned with ARI s foundational principles ethics and common agenda Aligned with ARI strategies identified by other workgroups Supports trauma informed culturally responsive systems and processes Increases Alaskans understanding of trauma resilience Evidence and or Practice Based Alaska data supports or indicates need If applicable Recognized as an evidenced based strategy or best practice If applicable Success is demonstrated elsewhere in Alaska or the United States Magnitude Impact Creates a direct positive impact on Alaskan children Potential impacts are high magnitude or effect changes on a population level Supports an upstream versus downstream solution Potential to create lasting sustainable positive change in Alaska Feasibility Sustainability ARI adds unique value We are a credible source on this topic Other key stakeholders in the field would endorse support this If applicable Funding exists to support policy changes If applicable Enjoys bipartisan support If applicable Supported endorsed by local level coalitions If applicable Supported endorsed by aligned with other state level coalitions If applicable Supported endorsed by aligned with state government tribes or tribal organizations If applicable A bill has been introduced URGENCY Failure to act has severe negative impacts on wide range of people groups e g medical providers business community nonprofits childcare providers tribes or tribal organizations governments individuals families Failure to act damages credibility RISKS DRAWBACKS Would pursuing this policy issue or would implementation of this policy likely have the following effects Acting may have severe negative impacts on wide range of medical providers schools business community nonprofits tribes or tribal organizations including a waiver of sovereign immunity governments or peoples Acting may damage ARI s credibility reputation Acting may damage the backbone agency s credibility reputation Acting may put at risk ARI or backbone agency s relationships with funders Acting may cause potential damage due to unintended impacts Taking the lead would be perceived as stepping on toes or reinventing the wheel due to another group or coalition already leading the effort Contact ARI for additional information on their decision matrix including how the above criteria are scored https www akresilience org contact 1 8

What advocacy roles can networks play There are many different roles that networks can take on to promote policies across Purtle s framework The table below includes some examples These categories are fluid and are not meant to be restrictive Bear in mind that a network may take on multiple roles and switch across roles as needed NETWORK ROLES IN POLICY AND ADVOCACY Note ACEs trauma and resilience ATR Send MARC examples of how your network has played these roles or share a new role See Additional Resources ACEs Connection Campaign for TraumaInformed Policy and Practice 9

See Additional Resources Alaska Resilience Initiative Two primary sources of data on ACEs when appealing to policymakers Budget prevalence include the Behavioral Risk impact and cost effectiveness were identified Factor Surveillance System s Adverse as very important features of behavioral Childhood Experiences optional module health research by both Democrat and https www cdc gov violenceprevention Republican state legislators The Washington acestudy ace_brfss html and the National State Institute for Public Policy maintains a Survey of Children s Health https www database of benefit cost findings http www childhealthdata org browse survey wsipp wa gov BenefitCost for a variety of allstates q 5545 Many other surveys public policy topics many of which relate to have been done as well including the ACEs and trauma NEED DATA Philadelphia Expanded ACE Study http Note that efforts to prevent ACEs or build Networks with their strong resilience are often subject to the wrong cross sector partnerships may pockets problem Roman 2015 where those be critical in helping address the bearing the cost of implementing policies and wrong pockets problem Let Recent research from Purtle Dodson Nelson programs do not receive the primary benefits MARC know how your network Meisel and Brownson 2018 highlights the or savings has captured collective costs and www philadelphiaaces org philadelphia acesurvey Prevalence data can help you create urgency among policymakers importance of economic evaluation data benefits to help make your case 10

See Additional Resources Voices for Virginia s Children Note that there may be limits on some of the roles outlined here based on legal restrictions limitations placed by funders and other factors Being part of a network however provides opportunities for partners to play certain roles by performing activities that other members may not be able to engage in At least initially networks might find the idea of advocating for trauma preventive policies that take on major economic and social problems to be beyond their capacity and expertise However the combination of small contributions made by a wide and diverse group of organizations playing these various roles can be the deciding factor in how an issue is resolved even though the path is often long and uncertain 11

ADVOCACY AND LOBBYING KNOW WHAT S POSSIBLE Sometimes the fear of violating lobbying restrictions limits activity unnecessarily Even 501 c 3 public charities may lobby as long as the lobbying does not comprise a substantial part of the organization s total activity However grant funding often comes with additional restrictions so it is important to know and understand fully the approved uses of all funding supporting your network The table below provides specific examples from trauma related advocacy and lobbying The bottom line Know what s possible it might be more than you think See Additional Resources ACEs Connection EXAMPLES OF ADVOCACY VS LOBBYING ACTIVITIES ADAPTED FROM NACCHO 2018 ADVOCACY LOBBYING Meeting with an elected official to educate Meeting with an elected official to urge them them about the importance of funding to vote for a bill to provide funding for your trauma informed programs for your organization s trauma programs community Preparing educational materials that depict Preparing materials that include information success stories from your local initiative on trauma informed programs and contain messaging for or against specific legislation Tweeting statistics about trauma and Tweeting a message a member of Congress descriptions of how trauma informed urging the member to vote against budget programs can reduce ACEs and build cuts for specific programs that reduce ACEs resilience and trauma Sending a weekly e newsletter discussing E mailing a call to action to members of factual information on ACEs and trauma your organization to encourage them to and outlining programmatic efforts that are contact their legislator in favor of specific proven to reduce this health issue legislation Furthermore when other advocacy efforts for public policy solutions to major economic and social problems stall networks can advance the dialogue by elevating the trauma question They can ask What role does the ACEs trauma and resilience science play in understanding responding to and preventing this problem With this shift in narrative comes the opportunity to connect the dots between seemingly insurmountable economic and social problems adverse community experiences and ACEs Helping others to do the same creates the possibility for different policy solutions and shared responsibility to act 12

Case study Addressing secondary traumatic stress among City of Philadelphia employees TAKING ON POLICY THE PHILADELPHIA ACE TASK FORCE STORY The Philadelphia ACE Task Force PATF was established in 2012 Today it is a diverse cross sector network comprising more than 200 members representing a wide array of public private and non profit organizations from health care to faith along with community residents and activists In 2017 an in depth strategic planning process established a new goal for the Task Force to advocate for policies that reduce ACEs and promote resilience WHAT POLICY ISSUE IS PATF WORKING ON As its initial effort PATF is pursuing policy solutions to prevent and mitigate the impact of secondary traumatic stress STS The focus on STS and policy began in 2016 when PATF organized an ACE film festival and screened the film Portraits of Professional Caregivers Their Passion Their Pain which depicts diverse professionals impacted by STS and presents strategies to address it The screening raised awareness about STS among the 250 people in attendance and spurred interest among several members of the Philadelphia City Council SECONDARY TRAUMATIC STRESS A documented condition that mirrors the symptoms and negative consequences of post traumatic stress disorder It is the emotional duress that results when an individual hears about the firsthand trauma experiences of another The National Child Traumatic Stress Network n d Those who work with people who have experienced primary trauma are at high risk for STS which can compromise professional functioning and overall quality of life STS is associated with high staff turnover burnout absenteeism and poor performance 13

Energized by the attention to STS at the City Council level a small group of PATF Have a network policy case leaders and the Caregivers filmmakers began meeting with interested City Council study to share Send MARC a members to plan a series of events to build awareness about the prevalence and short write up

PHILADELPHIA ACE TASK FORCE POLICY TIMELINE Milestones and Network Roles 15

Conclusion As the trauma informed movement grows in strength around the country the time is ripe for community based cross sector networks to unlock their power and increase their involvement in public policy at all levels of government This toolkit is an initial We want to hear from you Please share your comments successes and challenges effort to demystify the process and provide ideas and strategies to support this mobilization Additional Resources ACES CONNECTION ACEs Connection a social network with 33 000 members connects those who are implementing trauma informed and resilience building practices based on ACEs science The members share their best practices while inspiring each other to grow the ACEs movement For policy focused information check out the State ACEs Action and Resilience USA communities https www acesconnection com Growing Resilient Communities 2 0 is a basic framework that supports any approach to launching ACEs initiatives in a community The four parts educate engage activate and celebrate are critical to the success of a local ACEs initiative https www acesconnection com blog growing resilient communities 2 0 Strategic Advocacy Winning Policy Change without Crossing the Lobbying Line March 2019 is a webinar co hosted by ACEs Connection and the Campaign for Trauma Informed Policy and Practice Featured speakers share how to drive public policy change without violating the restrictions on non profits organizations or the requirements of funders A summary of the webinar is also available https youtu be TMLCGxrSmYc https www acesconnection com blog webinar strategic advocacy winning policychange without crossing the lobbying line held march 14 16

ALASKA RESILIENCE INITIATIVE ARI Policy Victory SB 105 briefly documents the content background and next steps regarding Alaska s Senate Bill 105 https static1 squarespace com static 58e7e4676a496342ee566554 t 5bc28f635345 0a5777d4e6c2 1539477350140 SB 105 story for website pdf Toward a Trauma Informed Resilient and Culturally Responsive Alaska briefly describes the Alaska approach to trauma and resilience and highlights exemplary models of change from across the country https static1 squarespace com static 58e7e4676a496342ee566554 t 5bba4de815fc c04e6ffa6f87 1538936317491 TraumaInformed_final_print pdf New Alaska Statute Directs State Policy to Incorporate Trauma Principles January 2019 is a webinar co hosted by ACEs Connection and the Campaign for TraumaInformed Policy and Practice featuring ARI s director Laura Norton Cruz and Representative Geran Tarr https youtu be uH q4GGYPdc BUILDING COMMUNITY RESILIENCE INITIATIVE The Pair of ACEs Tree image grew out of the need to illustrate the relationship between adversity within a family and adversity within a community https publichealth gwu edu sites default files downloads Redstone Center Resource 20Description_Pair 20of 20ACEs 20Tree pdf The BCR Policy and Advocacy Guide March 2018 is intended to assist you and your organization in becoming effective policy advocates and educators It provides guidance to help you identify and act on policy opportunities that will ultimately prevent and mitigate the Pair of ACEs and build community resilience to help children families and communities thrive https publichealth gwu edu sites default files downloads Redstone Center BCR 20Policy 20and 20Advocacy 20Guide pdf CAMPAIGN FOR TRAUMA INFORMED POLICY AND PRACTICE A Guide to Trauma Informed Advocacy December 2017 covers the basics how Congress works and three elements of a successful legislative strategy organize educate advocate It also includes information on CTIPP s Community Action Networks http www ctipp org wp content uploads 2019 02 CTIPP_Advocacy_Tips_113017 pdf See also Strategic Advocacy Winning Policy Change without Crossing the Lobbying Line under ACEs Connection 17

CENTERS FOR DISEASE CONTROL AND PREVENTION Preventing Child Abuse and Neglect A Technical Package for Policy Norm and Programmatic Activities 2016 from CDC s Division of Violence Prevention represents a select group of strategies based on the best available evidence to help prevent child abuse and neglect These strategies range from a focus on individuals families and relationships to broader community and societal change Examples include strengthening economic supports to families and providing quality care and education early in life https www cdc gov violenceprevention pdf can prevention technical package pdf FUTURES WITHOUT VIOLENCE Changing Minds Preventing and Healing Childhood Trauma State Policy Guide January 2018 was developed to address how health education child welfare justice and child development organizations can further the prevention and healing of childhood trauma at the state level It outlines approaches that can be adapted based on a state s circumstances and community needs and addresses the reality that children grow up and develop in the context of their families communities and cultures https www futureswithoutviolence org changing minds preventing healingchildhood trauma state policy guide ILLINOIS ACES RESPONSE COLLABORATIVE Policy Briefs Health Justice and Education highlight the impact of ACEs on three systems and include promising practices and recommended actions for change Developed by members of the Collaborative these briefs serve as a call to action to move upstream and recognize how addressing inequity and trauma can improve systems while also building resiliency http www hmprg org programs illinois aces response collaborative policy briefsreports Trauma Informed Policymaking Tool outlines a policy approach to preventing and healing from trauma The two page Tool defines trauma informed principles and describes their application to both the process of policymaking and its outcome http hmprg org wp content uploads 2019 05 TI Policymaking Final pdf PACIFIC SOUTHWEST MENTAL HEALTH TECHNOLOGY TRANSFER CENTER Creating Trauma Informed Policies A Practice Guide for School and Mental Health Leadership provides a deep dive into developing implementing and evaluating trauma informed and compassionate school policies It highlights four choice points for education and mental health leadership Names Definitions Platforms Levers Approach and Match Process to Product Each choice point comes with examples guiding questions for leadership and practice suggestions to help policy come alive A companion webinar February 2019 is also available in which presenters share how to 18

create and develop policies that contribute to trauma informed school environments and tips for ensuring trauma informed work is sustainable and scalable at your school district office agency department or organization http cars rp org _MHTTC docs Trauma Informed Policies pdf https www youtube com watch v rSZLGFSiZAk PHILADELPHIA ACE TASK FORCE Public Hearing on Secondary Traumatic Stress and Resiliency Programs for Professional and Family Caregivers and First Responders On Friday December 7 2018 the Committee on The Disabled and Persons with Special Needs of the Council of the City of Philadelphia held a Public Hearing to hear testimony on the following item 180041 Resolution authorizing the Committee on the Disabled and Persons with Special Needs to hold hearings regarding professional and family caregivers and first responders in the City of Philadelphia https youtu be ezOfK4_eRmo PREVENTION INSTITUTE Adverse Community Experiences and Resilience webpage houses numerous valuable resources on how to understand address and prevent community trauma It provides one stop access to the ACE R framework related publications answers to FAQs videos and community examples https www preventioninstitute org projects adverse community experiences andresilience understanding addressing and preventing Collaboration Multiplier is an interactive framework and tool for analyzing collaborative efforts across fields It is designed to guide an organization to a better understanding of which partners it needs and how to engage them It is also designed for organizations that already work together so they may identify activities to achieve a common goal identify missing sectors that can contribute to a solution delineate partner perspectives and contributions and leverage expertise and resources https www preventioninstitute org tools collaboration multiplier VOICES FOR VIRGINIA S CHILDREN The Future of Virginia Starts Today 2017 Elections Guide is a powerful tool that can be used by organizations and individuals for voter education and advocacy It features several elements that provide talking points candidate questions data and useful information on the issues that affect Virginia s children the most https vakids org take action elections election toolkit 19

AND MORE FROM MOBILIZING ACTION FOR RESILIENT COMMUNITIES From Film Festival to City Council Chambers Philadelphia ACE Task Force Charts a Path toward Policy Change on Secondary Traumatic Stress March 2019 http marc healthfederation org shared learnings film festival city council chambersphiladelphia ace task force charts path toward Shaping Policy Top Down and Bottom Up May 2018 http marc healthfederation org shared learnings shaping policy top down and bottom State Level Recommendations for Establishing the Building Blocks for Lifelong Health and Success June 2017 http marc healthfederation org state level recommendations establishing buildingblocks lifelong health and success From Problems to Issues Making Trauma Informed Policy Change March 2017 http marc healthfederation org shared learnings from problems to issues makingtrauma informed policy change Using Film to Mobilize Action August 2016 http marc healthfederation org shared learnings using film mobilize action References Alliance for Justice 2018 Bolder Advocacy glossary Retrieved from https www bolderadvocacy org afj on advocacy glossary Bowen E A Murshid N S 2016 Trauma informed social policy A conceptual framework for policy analysis and advocacy American Journal of Public Health 106 2 223 229 doi 10 2105 AJPH 2015 302970 Brownson R C Chriqui J F Stamatakis K A 2009 Understanding evidence based public health policy American Journal of Public Health 99 9 1576 1583 Felitti V J Anda R F Nordenberg D Williamson D F Spitz A M Edwards V Koss M P 1998 Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults The Adverse Childhood Experiences ACE Study American journal of Preventive Medicine 14 4 245 258 20

Fortson B L Klevens J Merrick M T Gilbert L K Alexander S P 2016 Preventing child abuse and neglect A technical package for policy norm and programmatic activities National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta GA Retrieved from https www cdc gov violenceprevention pdf can prevention technical package pdf McEwen C A McEwen B S 2017 Social structure adversity toxic stress and intergenerational poverty An early childhood model Annual Review of Sociology 43 445 472 National Association of County and City Health Officials 2018 The NACCHO advocacy toolkit NACCHO Washington DC Retrieved from https www naccho org uploads downloadable resources Government Advocacy Toolkit April 20181 pdf The National Child Traumatic Stress Network n d Secondary traumatic stress Retrieved from https www nctsn org trauma informed care secondary traumatic stress Nellis A 2016 The color of justice Racial and ethnic disparity in state prisons The Sentencing Project Washington DC Retrieved from http www sentencingproject org publications color of justice racial and ethnic disparity in state prisons Pinderhughes H Davis R A Williams M 2015 Adverse community experiences and resilience A framework for addressing and preventing community trauma Prevention Institute Oakland CA Prevention Institute 2018 March Full recommendations for preventing gun violence Prevention Institute Oakland CA Retrieved from http preventioninstitute org publications prevention institute full recommendations preventing gun violence Purtle J Dodson E A Nelson K Meisel Z F Brownson R C 2018 Legislators sources of behavioral health research and preferences for dissemination Variations by political party Psychiatric Services published online 7 9 2018 doi org 10 1176 appi ps 201800153 Roman J 2015 September 29 Solving the wrong pockets problem How Pay for Success promotes investment in evidence based best practices Urban Institute Washington DC Retrieved from https www urban org research publication solving wrong pockets problem Schmid T L Pratt M Howze E 1995 Policy as intervention Environmental and policy approaches to the prevention of cardiovascular disease American Journal of Public Health 85 9 1207 1211 Stevens J 2017 November 1 ACEs science 101 FAQs Blog post Retrieved from https www acesconnection com blog aces 101 faqs 21

HEALTH FEDERATION OF PHILADELPHIA The Health Federation of Philadelphia HFP serves as a keystone supporting a network of Community Health Centers as well as the broader base of public and private sector organizations that deliver health and human services to vulnerable populations We take a collaborative approach to promoting health by Improving access to and quality of health care Identifying testing and implementing solutions to health disparities Providing training and technical assistance to help other organizations operate more efficiently and effectively For more information visit www HealthFederation org THE CALIFORNIA ENDOWMENT The California Endowment a private statewide health foundation was established in 1996 to expand access to affordable quality health care for underserved individuals and communities and to promote fundamental improvements in the health status of all Californians Headquartered in downtown Los Angeles The Endowment has regional offices in Sacramento Oakland Fresno and San Diego with program staff working throughout the state The Endowment challenges the conventional wisdom that medical settings and individual choices are solely responsible for people s health The Endowment believes that health happens in neighborhoods schools and with prevention For more information visit www CalEndow org ACES CONNECTION ACEs Connection is a social network with 33 000 members that recognizes the impact of a wide variety of adverse childhood experiences ACEs in shaping adult behavior and health and that promotes trauma informed and resiliencebuilding practices and policies in all families organizations systems and communities We support 400 communities to accelerate the science of adverse childhood experiences to solve our most intractable problems We believe that we can create a resilient world where people thrive For more information visit www ACEsConnection com CAMPAIGN FOR TRAUMA INFORMED POLICY AND PRACTICE The Campaign for Trauma Informed Policy and Practice CTIPP was created in December 2016 by 25 representatives from diverse sectors including education mental health justice and government We share a common commitment to inform and advocate for public policies and programs at the federal state tribal and local levels that incorporate scientific findings regarding the relationship between trauma and related social and health challenges across the lifespan We work in collaboration with government organizations and citizens to develop trauma informed prevention focused evidenceinformed policies and practices that promote a comprehensive integrated multi sector approach for building traumainformed communities For more information visit www CTIPP org