Unchartered Waters

An Update from Rick Murdock, Michigan ACE Coordinator

First, I hope this message finds you, your families and colleagues in good health. As we work through the “shelter at home” directive in effect for the coming weeks, if not longer, it gives us the context to think of our next steps for the Michigan ACE Initiative. I don’t think that I am unique in pondering the relationship between ACEs and the effects to the family due to the insidious ravages of COVID-19. We are in unchartered waters in one sense, but I think all would agree that the stress, uncertainty, and anxiety of this virus can only exacerbate the already known short- and long-term effects of ACEs. We are already seeing increases in domestic violence and children hospitalized for child abuse.Whether we classify COVID-19 as its own ACE score, we do anticipate that COVID-19 will introduce its own kind of trauma as individuals and communities struggle with the impact of long-term isolation and lack of social connection, economic downturn, and potentially unanticipated numbers of fatalities due to the virus. These environmental stresses will exacerbate the already existing adversity for both children and adults. Clearly, we will need to work closely with you, communities and leaders to identify what additional supports and/or modifications to the ACEs work are necessary to address these stresses.

ACE Screening and Virtual Presentations

Let me address two related issues that have emerged in the past weeks and months. As many of you know, there has been some discussion among participants and followers of the ACE Initiative—here in Michigan and nationwide—regarding how best to proceed with screening and the appropriate use of the ACE “score”.The activity in California, led by the Center for Youth Wellness has led to a more robust discussion on this issue and the confusion has taken place regarding the use of the ACE score for general public use vs. clinical setting and appropriate screening tools. Dr. Rob Anda (co-researcher of the original ACE Study that developed the ACE score), Laura Porter, and David Brown have recently published an article in the American Journal of Preventive Medicine (Link below) regarding the inappropriate use of the ACE score in predicting future individual health status—and that its intent was on a population-based approach. The three page article, easily read is at: https://www.ajpmonline.org/article/S0749-3797(20)30058-1/fulltext

Second, last week, upon consultation with Rob Anda and Laura Porter from ACE Interface (who produces the materials used by Michigan ACE Master Trainers), Lisa Farnum of the Michigan ACE Initiative developed a memo offering guidance on using ACE Interface materials in virtual presentations. Because of the “Shelter at Home” directive, based on the guidance of Dr. Anda and Laura Porter (ACE Interface), the Michigan ACE Initiative recommends not providing ACE 101 and NEAR trainings online. We will wait to see how long it may be before we can resume in-person training and will revisit this in May. In the meantime, we will work to support Master Trainers and Michigan ACE Community Champions (MACCs) by sharing and developing webinars, zoom meetings, and podcasts to increase expertise and address next steps.

Other Items

You should be aware of the postponement of the ACE Conference we were planning to hold in May—this has been rescheduled for Thursday, November 5th at the Eagle Eye Conference Center. Please hold the date and the program will be revised to take into account the recent events in Michigan on COVID-19, the efforts that we are developing regarding next steps toward resilience and lessons from the field (best practices). Also, please be aware that on your behalf we are finalizing several funding proposals to begin the work on taking on the “next steps”. The focus will be on how do we move into interventions, resilience, and where does that affect social determinants of health. Thanks to Jennifer Nottingham and the Michigan Public Health Institute for extensive development of best practice development protocols that will add sustainability to our funding efforts and subsequent implementation.

Summary

I want to end with part of the message that I started with—how do we address COVID-19? For many of the reasons stated above and in other documents, the Michigan ACEs network may be in position to be one of the “solutions” that will be “boots on the ground” to address the “back end” issues that families have faced with COVID-19. That is the backdrop in my mind and as we work on policy, funding proposals, and presentation materials. I am hopeful we can continue to meaningfully link these two issues.

Please stay healthy, stay home, and practice all of the protective measures listed by our health care providers.

-Rick