This report was published by Public Health Ontario.

HERE’S HOW THE AUTHORS DESCRIBE THIS REPORT:

Adverse Childhood Experiences (ACEs) are defined as potentially traumatic events, such as emotional, physical or sexual abuse experienced in the first 18 years of life. Preventing ACEs has been proposed as an upstream intervention to impact physical and mental health and health-related behaviours, such as substance use. The objective of this study was to identify effective public health approaches implemented in Canada to prevent or mitigate the impact of ACEs.

A search for peer-reviewed literature was conducted by Public Health Ontario’s Library Services using four databases: MEDLINE, EMBASE, PsycINFO and SocINDEX. Inclusion criteria were primary studies published in the past 10 years, conducted in Canada and assessment of a program or intervention that addressed one or more ACEs. Two independent reviewers screened titles and abstracts, followed by full-text articles and conducted quality appraisal on the included studies.

A total of 1,071 potentially-relevant references were identified by the search, of which 96 full-text articles were retrieved and screened. Thirty-two of those articles were assessed for quality with data extracted. Most studies (N=17) were identified as moderate quality, nine studies were identified as strong quality, and six studies were identified as weak quality. There were 26 different programs described from six provinces: Ontario, Québec, Alberta, British Columbia, Manitoba, and Saskatchewan. Programs were conducted in four main settings: home, school, community or in a clinic/healthcare setting. The goal of 60% of the programs was to focus on prevention of a known ACE. The main ACEs that were targeted included child exposure to intimate partner violence, substance use by a parent, and child maltreatment.

Strategies to address ACEs in Canada were heterogeneous and implemented in many settings by multiple organizations across varied sectors, including public health, social services, and health care. Most programs targeted only one of the 10 ACEs and required strong partnership with additional community agencies involved in children’s services. Preventing and mitigating the impacts of ACEs through strategies such as building resilience and supporting the awareness of ACEs in public health programming may be the next steps for supporting communities.