RFA-CE-25-025_20240829.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL

Rigorous Evaluation of Community- and Societal-Level Primary Prevention Approaches to Prevent Adverse Childhood Experiences (ACEs): Expanding the Best Available Evidence

RFA-CE-25-025

12/02/2024

Table of Contents Section I. Funding Opportunity Description

Section II. Award Information

Section III. Eligibility Information

Section IV. Application and Submission Information

Section V. Application Review Information

Section VI. Award Administration Information

Section VII. Agency Contacts

Section VIII. Other Information

Overview

Participating Organization(s) Centers for Disease Control and Prevention Components of Participating Organizations Components of Participating Organizations:

National Center for Injury Prevention and Control Notice of Funding Opportunity (NOFO) Title Rigorous Evaluation of Community- and Societal-Level Primary Prevention Approaches to Prevent Adverse Childhood Experiences (ACEs): Expanding the Best Available Evidence Activity Code Applications in response to this Notice of Funding Opportunity (NOFO) will be funded using the U01 activity code for a research grant.

Notice of Funding Opportunity Type New Agency Notice of Funding Opportunity Number

RFA-CE-25-025

Assistance Listings Number(s) 93.136 Category of Funding Activity HL - Health NOFO Purpose The purpose of this research announcement is to support investigator-initiated research to rigorously evaluate policies or programs for the primary prevention of adverse childhood experiences (ACEs). In alignment with NCIPC’s ACEs Research Priorities, projects are expected to evaluate primary prevention approaches at the community- or societal-level that address the social or structural conditions that place some populations at greater risk for ACEs.

Research conducted with these funds will rigorously evaluate existing primary prevention approaches (i.e., policies or programs that are already developed and implemented or have been shown to be ready for implementation in the community or population of interest) that have not yet undergone rigorous evaluation and are not currently undergoing rigorous evaluation for prevention of ACEs.

Research funded under this announcement is intended to expand the evidence base for ACEs prevention in one or more of the following strategy areas identified in the CDC’s ACEs Prevention Resource for Action.

Key Dates Publication Date:

To receive notification of any changes to RFA-CE-25-025, return to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notification Emails" link.

An email address is needed for this service.

Letter of Intent Due Date:

11/01/2024

While a letter of intent is not mandatory, nor is it binding or a factor in the review of an application, the details it provides help NCIPC staff to plan for the scientific and technical merit peer review process.

Application Due Date:

12/02/2024

On-time submission requires that electronic applications be error-free and made available to CDC for processing from the NIH eRA system on or before the deadline date. Applications must be submitted to and validated successfully by Grants.gov no later than 11:59 PM U.S. Eastern Time.

Applicants will use a system or platform to submit their applications through Grants.gov and eRA Commons to CDC. ASSIST, an institutional system to system (S2S) solution, or Grants.gov Workspace are options. ASSIST is a commonly used platform because it provides a validation of all requirements prior to submission and prevents errors.

For more information on accessing or using ASSIST, you can refer to the ASSIST Online Help Site at: https://era.nih.gov/erahelp/assist. Additional support is available from the NIH eRA Service desk via http://grants.nih.gov/support/index.html.

• E-mail: commons@od.nih.gov

• Phone: 301-402-7469 or (toll-free) 1-866-504-9552

• Hours: Monday - Friday, 7 a.m. to 8 p.m. Eastern Time, excluding Federal holidays

Note: HHS/CDC grant submission procedures do not provide a grace period beyond the application due date time to correct any error or warning notices of noncompliance with https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf https://www.grants.gov/ http://grants.nih.gov/support/index.html mailto:commons@od.nih.gov application instructions that are identified by Grants.gov or eRA systems (i.e., error correction window).

Scientific Merit Review:

02/25/2025 This date is an estimate

Secondary Review:

05/30/2025 This date is an estimate

Estimated Start Date:

09/30/2025 Expiration Date:

03/10/2025 Required Application Instructions It is critical that applicants follow the instructions in the How to Apply - Application Guide except where instructed to do otherwise in this NOFO. Conformance to all requirements (both in the Application Guide and the NOFO) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions.

Note:The Research Strategy component of the Research Plan is limited to 12 pages.

Page Limitations: Pages that exceed the page limits described in this NOFO will be removed and not forwarded for peer review, potentially affecting an application's score.

Applications that do not comply with these instructions may be delayed or may not be accepted for review.

Telecommunications for the Hearing Impaired: TTY 1-888-232-6348

Executive Summary Purpose

The Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (NCIPC) is soliciting investigator-initiated research that will help expand and advance our understanding about what works to prevent ACEs. In alignment with NCIPC’s ACEs Research Priorities, this initiative is intended to support the evaluation of existing community- or societal-level primary prevention policies or programs that address social and health inequities that place some populations at greater risk for ACEs.

There are three specific research objectives for this NOFO:

• Research Objective 1: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions and ensure a strong start for children.

https://grants.nih.gov/grants/how-to-apply-application-guide.html

• Research Objective 2: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions and promote social norms and narratives that protect against violence and adversity.

• Research Objective 3: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions and strengthen economic supports to families.

Applicants must clearly indicate which of these objectives the research proposal intends to address. Applicants must demonstrate that the selected approach is currently being implemented or ready for implementation in the community or population of interest (e.g., through formative research evidence, pilot data, or community letters of support) and is ready for rigorous evaluation.

Applicants must propose rigorous evaluation designs, which for the purposes of this funding opportunity can include those that utilize experimental designs (i.e., randomized controlled trials) or quasi-experimental designs (e.g., comparative interrupted time series design with multiple time points).

Applicants are required to address the prevention of at least one form of child abuse and/or neglect (CAN) and at least one additional ACE (additional details in Approach section).

Applicants are strongly encouraged to evaluate impacts of the selected approach on several ACEs.

All applicants are required to address how the selected approach will address the social or structural conditions that put some populations at greater risk for ACEs and to empirically examine the health equity implications of their selected approach.

Mechanism of Support The funding mechanism for this Notice of Funding Opportunity (NOFO) will be a Research Cooperative Agreement (U-01).

Funds Available and Anticipated Number of Awards CDC/NCIPC intends to commit up to $900,000 in FY 2025 to fund up to two (2) applications.

Awards issued under this NOFO are contingent upon availability of funds and a sufficient number of meritorious applications.

Budget and Period of Performance The maximum award amount will be $450,000 per award for the first 12-month budget period.

This includes both direct and indirect costs. An applicant may request a period performance of up to three years. The maximum total project funding amount is $1,350,000 (including both direct and indirect costs) over the expected period of performance length, with a maximum of $450,000 per award per year. The period of performance for this award is expected to run from 9/30/2025 to 9/29/2028.

Application Research Strategy Length Page limits for the Research Strategy are clearly specified in Section IV. Application and

Submission Information of this announcement.

Eligible Institutions/Organizations Institutions/organizations listed in Section III. Eligibility Information 1. Eligible Applicants are eligible to apply.

Eligible Project Directors/Principal Investigators (PDs/PIs) The CDC does not award individuals directly. Individuals possessing the necessary skills, knowledge, and resources to conduct proposed research should collaborate with their institutions to submit a support application. Underrepresented racial and ethnic groups, as well as individuals with disabilities, are especially encouraged to apply.

For applications where the contact PD/PI qualifies as an NIH Early Stage Investigator (ESI), as confirmed through the NIH Investigator Status determination process, and has a commendable peer review score, prioritization may occur during the second level of review (refer to Section V.

Application Review Information 4. Review and Selection Process). Regarding the determination of Investigator Status for the contact PD/PI:

Before submitting an application, PD/PIs should confirm or update the date of their terminal research degree or the conclusion of their post-graduate clinical training in their eRA Commons Profile for accurate identification. NIH systems will automatically determine each investigator's status and reflect it in their eRA Commons personal profile. The ESI status for PD/PIs on any R01 or equivalent application will be indicated at submission. Investigators must ensure their status is accurately represented in their profile. If the status is incorrect, they should reach out to the NIH eRA Service Desk.

Number of PDs/PIs An application may name more than one PD/PI; their names must appear on the face page of the application. However:

• One (1) principal investigator must be designated as the contact PD/PI for all correspondence related to the application.

• All PD/PIs must include their eRA Commons Identification in the Credential Field of the Senior/Key Person Profile Component of the SF-424 (R&R) Application Package.

• Institutions/organizations proposing multiple PDs/PIs must visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF-424 (R&R) Application Guide.

Number of Applications Organizations eligible to apply may submit multiple applications to this NOFO, as long as each is scientifically distinct. However, institutions may only submit one application per contact PD/PI. Only one application for each contact PD/PI will receive funding under this announcement. If multiple applications from the same contact PD/PI are submitted, only the most recent one, based on the time and date stamp at www.grants.gov, will be considered for review. It is the applicant's responsibility to withdraw any duplicate applications before the review date.

https://grants.nih.gov/policy/early-stage/index.htm https://www.era.nih.gov/need-help

Institutions that submit applications proposing essentially the same research to two or more CDC/ATSDR NOFOs will not receive funding for more than one.

Application Type

NEW

Special Date(s) A pre-application teleconference call will be conducted on 10/09/2024 to address questions from prospective applicants regarding NOFO RFA-CE-25-025. The call will begin at 2:00pm Eastern Standard Time (EST) and end at 2:50 pm Eastern Standard Time (EST), or sooner if all questions are addressed. Questions and answers from the discussion will be included in a supplemental document on grants.gov approximately 2-3 weeks after the call.

Participant Access Information:

• Call Date: October 9, 2024

• Call Start Time: 2:00pm Eastern Standard Time (EST)

• Call End Time: 2:50pm Eastern Standard Time (EST)

• Call Leader: Joyce Dieterly, Scientific Program Official

• Webinar Link:

https://cdc.zoomgov.com/j/1609443938?pwd=eGtXYUdFa2RXK0tQTWxGR3doVzA5U T09

• Webinar ID: 160 944 3938

• Passcode: 6+!QCgQE

• Call-In Numbers:

o +1 646 828 7666 US (New York) o +1 646 964 1167 US (US Spanish Line) o +1 669 254 5252 US (San Jose) o +1 551 285 1373 US (New Jersey) o +1 415 449 4000 US (US Spanish Line) o +1 669 216 1590 US (San Jose)

• Dial-In Passcode: 42055153

Application Materials See Section IV.1 for application materials.

Hearing Impaired Telecommunications for the hearing impaired are available at: TTY: 1-888-232-6348.Section I.

Funding Opportunity Description

Section I. Funding Opportunity Description

Statutory Authority https://cdc.zoomgov.com/j/1609443938?pwd=eGtXYUdFa2RXK0tQTWxGR3doVzA5UT09 https://cdc.zoomgov.com/j/1609443938?pwd=eGtXYUdFa2RXK0tQTWxGR3doVzA5UT09

Section 301 (a) (2) [42 U.S.C. 241(a)] of the Public Health Service Act, and Section 391 (a) [42 U.S.C. 280 b (a)] of the Public Health Service Act, as amended.

1. Background and Purpose Adverse Childhood Experiences, or ACEs, are preventable, potentially traumatic events that occur in childhood (0–17 years). Examples of ACEs include neglect, experiencing or witnessing violence, or having a family member attempt or die by suicide. ACEs also include aspects of a child’s environment that can undermine their sense of safety, stability, and bonding, such as living in a household where a parent or caregiver is negatively affected by substance use or an ongoing serious mental health condition, or when a child experiences instability due to prolonged separation from a parent or caregiver (CDC, 2019; Felitti et al., 1998). ACEs are associated with a wide range of adverse behavioral, health, and social outcomes, including: substance abuse;

mental health conditions such as depression and anxiety; chronic diseases such as asthma, heart disease and cancer; and harmful impacts on educational attainment and earnings potential (Merrick et al., 2019; Petruccelli et al., 2019; Peterson et al., 2023). ACEs are common, but some children experience both an inequitable burden of ACEs and the negative impacts of ACEs on health and other outcomes. This inequitable burden is associated with historical and on-going social and structural conditions such as systemic racism, discrimination, and multigenerational poverty that limit access to life opportunities including quality education, economic security, stable housing and living in safe neighborhoods (Harper et al., 2023; Metzler et al., 2017; Nurius et al., 2012; Ports, Tang, Treves-Kagan & Rostad, 2021).

ACEs can be prevented before they happen, and there are strategies for reducing the potential harms of ACEs among those who have experienced them. CDC developed a resource Adverse Childhood Experiences Prevention Resource for Action (cdc.gov)to help states, tribes, and communities use the best available evidence to prevent ACEs from happening in the first place.

Although progress has been made to identify effective approaches for preventing ACEs, additional research is needed to evaluate and build this evidence base, particularly at the community- and societal-levels (Harper et al., 2023; Matjasko et al., 2022).

Additional background related to health equity:

This funding announcement supports CDC CORE Health Equity Goals to embed health equity principles in the design, implementation, and evaluation of its research, data, surveillance, and intervention strategies. For more information about CDC CORE Health Equity Goals, see https://www.cdc.gov/healthequity/core/index.html. Health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health (CDC, 2022a). Achieving this requires recognizing and addressing the systems of inequity that create economic, social, and other obstacles to health and health care, resulting in the disproportionate burden of ACEs among some populations. For example, systemic and structural racism are associated with lower well-being among racial and ethnic minority youth (Anderson, Eisenberg, & Zimmerman, 2023).

The likelihood of experiencing ACEs is high among some groups including individuals who are non-Hispanic Black, American Indian/Alaska Native, and persons of multiple races (Merrick et al., 2019; Swedo et al., 2023). Disproportionately impacted populations may include some racial/ethnic minority groups; tribal populations; persons with disabilities; persons experiencing homelessness; persons who are immigrants and refugees; sexual and gender minorities; and https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf https://www.cdc.gov/healthequity/core/index.html persons who hold multiple disproportionately impacted identities (Austin et al., 2020; Flores & Salazar, 2017; Hughes et al., 2022; Liu et al., 2021; Merrick et al., 2019; Swedo et al., 2023).

Of particular interest for this NOFO are evaluations of policies or programs that seek to prevent ACEs by addressing and improving social and structural determinants of health (SDOH). SDOH are the non-medical factors that influence health outcomes (CDC, 2022b). Examples of SDOH include economic policies and systems, social norms, social policies, racism, and climate change.

Public health approaches that focus on addressing upstream factors such as SDOH have the potential to reduce ACEs at the population-level and are less likely to perpetuate inequities (Lorenc et al., 2013; Hall et al., 2016). However, all programs and policies also have the potential to exacerbate health inequities or otherwise cause harm. This is particularly relevant when addressing the outer levels of the social ecology, as the increased reach magnifies the potential for both benefits and harm. As such, applicants are required to clearly describe how the health equity implications of the selected prevention approach will be empirically studied in population(s) disproportionately impacted by ACEs to ensure that the effort does not widen inequities (please see additional guidance under Section I. Funding Opportunity Description 2.

Approach).

Additional background on community- and societal-level approaches:

Approaches that are hypothesized to impact ACEs prevention at the outer levels of the social-ecological model (i.e., community and societal levels) are needed due to a limited evidence base.

Given that approaches at the outer levels have the potential to reach a large number of people, they also have the potential to demonstrate population-level impacts on preventing ACEs as well as reducing inequities in ACEs (Lorenc et al., 2013; Hall et al., 2016). Federal, state, local, tribal or organizational policy approaches typically seek to affect community or societal risk and protective factors, such as the climate or processes within the defined community (e.g., Dahlberg & Krug, 2002). For the purpose of this NOFO, a distinction is made between community-level approaches and community-based approaches. Community-level approaches are defined as approaches that target the characteristics of settings that increase or buffer against the risk for violence, particularly the social, economic, and environmental characteristics of neighborhood, school, workplace, and other organizational settings (Dahlberg, 2018).

Communities are defined as formal or informal organizations or geographical settings in which social relationships occur (e.g., neighborhoods, cities, states, etc.; Dahlberg & Krug, 2002).

Communities may include any defined population with shared characteristics, risk/protective factors, and potential for exposure to the policies or programs. Community-based approaches are implemented in community settings but address individual-, peer-, family-level interpersonal factors (e.g., conflict resolution skills, parenting skills, personal attitudes, knowledge about violence, bystander behaviors). Applications that propose to evaluate a community-based approach that addresses change in individual-, peer-, or family-level interpersonal factors, rather than change in societal or community conditions, do not meet the scientific intent of this NOFO.

Purpose:

The Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (NCIPC) is soliciting investigator-initiated research that will help expand and advance the understanding about what works to prevent ACEs and inform public health action. In alignment with NCIPC’s ACEs Research Priorities, this research announcement is intended to support the rigorous evaluation of existing community- or societal-level primary prevention policies or programs that address social and health inequities that place some populations at greater risk for ACEs. In addition, research funded under this announcement is intended to expand the evidence base for ACEs prevention in one or more of the following strategy areas identified in the CDC’s ACEs Prevention Resource for Action: Ensure A Strong Start for Children, Promote Social Norms That Protect Against Violence and Adversity, and Strengthen Economic Supports to Families. Applicants must propose studies focused on preventing at least one form of child abuse and neglect (CAN; e.g., physical abuse, emotional neglect) and at least one additional ACE outside of CAN. Applicants are strongly encouraged to evaluate impacts of the selected approach on multiple ACEs.

Additional background for specific research objectives:

Research Objective 1: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions by ensuring a strong start for children.

Ensuring a strong start for children and their families can have lasting protective impacts across the lifespan (CDC, 2019). Research has shown that high quality childcare and early childhood education may prevent ACEs by providing children with safe, stable environments for healthy childhood development (Fortson et al., 2016). Additionally, policies and programs that facilitate paid time for parents to bond with their children after birth or adoption are associated with improved parent/caregiver mental health outcomes (Bullinger, 2019; Irish et al., 2021; Van Niel et al., 2020), decreases in parent/caregiver intimate partner violence (Van Niel et al., 2020), improved infant health (Bullinger, 2019; Van Niel et al., 2020) and decreases in infant mortality outcomes (Montoya-Williams et al., 2020). Not all groups have access to such services and supports and more research is needed to broaden the evidence base within this strategy area may protect children from ACEs.

Potential research in response to this objective may include studies to assess the effectiveness of community- or societal-level approaches to increase access to, and availability and affordability of high-quality childcare or time for families to bond (e.g., access to affordable and quality childcare, universal pre-k, family-friendly work policies), efforts to close educational inequities such as disparities in school funding and graduation rates, and efforts to create safe and inclusive communities and classrooms. The examples described above are not an exhaustive list.

Applications should describe how the proposed research adds to the evidence base for the prevention of at least one form of CAN and at least one additional ACE outside indicators of CAN. The application should describe what is already known about the approach, including but not limited to a rigorous examination of health equity implications, and how the proposed research adds to public health knowledge and action.

https://www.cdc.gov/violenceprevention/pdf/ACEs-Prevention-Resource_508.pdf

Research Objective 2: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions by promoting social norms and narratives that protect against violence and adversity.

Promoting social norms that protect against violence and adversity is an important primary prevention strategy for creating the conditions in which all children can thrive (Klika & Linkenbach, 2019). Social norms refer to the shared beliefs and behaviors that are viewed as acceptable to a group or society (Edberg & Krieger, 2020). Social norms are influenced by the social and structural conditions of a society (Malhotra et al., 2019; Edberg & Krieger, 2020).

Access to the social and structural conditions needed for health and safety (e.g., economic security) is important for assuring that all people can achieve their optimal health and full life potential.

Not all groups have access to social and structural conditions that promote health, and explanations for why these behaviors and outcomes occur often do not include consideration of the contexts of people’s lives. For example, explanations for why ACEs occur often focus on the individual behaviors of parents, without acknowledging the impact of existing social and structural policies and practices (e.g., differential access to adequate income or quality education) that increase risk for ACEs among some children (Harper et al., 2024). Consequently, efforts to prevent early childhood adversity are largely informed by “narratives” (i.e., the way people think and talk about a problem and who is responsible for it) that attribute sole responsibility to parents (Metzler at al., 2017). Public narratives about the causes of ACEs (e.g., “bad parents”) shape our solutions to it (e.g., child separations vs. access to affordable childcare, adequate income).

Understanding how these dominant narratives operate and lifting up new, positive narratives are important for gaining support for solutions that can eliminate inequitable health burdens, including ACEs. Rigorous evaluation research is needed to strengthen the evidence base and to understand the efficacy of narrative change approaches to create societal- and community-level change and subsequent reductions in ACEs. Potential research funded under this objective includes studies to assess the effectiveness of community-level narrative change efforts to: 1) shift the perceived responsibility for children’s well-being from solely on individuals toward a shared responsibility within the larger community and society to create positive environments for children, or 2) promote societal norms that underscore the importance of creating access to the social determinants of health that protect children and families and eliminate risk for inequities in ACEs. For example, studies may consider evaluating narrative approaches that promote changes in public health, social welfare, and other related sectors to prevent unnecessary and traumatic child separations from caregivers and instead shift efforts toward creating positive and supportive environments for children and families. Studies proposing to examine social norms should avoid measuring individual attitudes (e.g., social workers’ perceptions about child separations) and instead measure informal standards of behavior shared by groups (e.g., acceptability of corporal punishment in a community).

The examples described above are not an exhaustive list. Applications should describe how the proposed research adds to the evidence base for the prevention of at least one form of CAN and at least one additional ACE outside of indicators of CAN. The application should describe what is already known about the approach, including but not limited to a rigorous examination of health equity implications.

Research Objective 3: Effectiveness research to evaluate existing primary prevention approaches that address societal- or community-level conditions by strengthening economic supports to families.

Research has consistently shown that poverty and low income are associated with increased risk of ACEs exposure (e.g., Skinner et al., 2023). Examples of societal-level economic supports include: Earned Income Tax Credits, Supplemental Nutrition Assistance Program, state minimum wage laws, and the Women Infants and Children program. These approaches have been associated with reductions in CAN (e.g., Austin et al., 2020; Holroyd et al., 2023; Kim et al., 2024; Klevens et al., 2017; Kovski et al., 2022; Maguire-Jack et al., 2022; Raissan and Bullinger, 2017; Wilkins et al., 2014).

More research is needed to determine the extent to which these strategies may impact multiple ACEs. For example, are approaches that are effective for reducing one specific ACE effective for reducing risk for a broader range of ACEs? Research is also needed on the evaluation of novel community- and societal-level approaches to strengthen economic supports that have not yet been rigorously evaluated for their impacts on ACEs. In addition, research to understand the equity implications of such approaches is needed to understand whether existing policies or programs equitably reach all populations they are intended to serve and whether approaches may potentially exacerbate the disparities they were intended to address.

Potential research in response to this objective includes studies to assess the effectiveness of economic approaches (e.g., cash transfer payments, nonpredatory lending through community development financial institutions (CDFIs)), livable wages or other policies to address inequities in employment and workplace settings, or other novel efforts to provide families with resources to meet basic needs (e.g., policies and/or programs that address inequities in access to quality healthcare and affordable housing). The examples described above are not an exhaustive list.

Applications should describe how the proposed research adds to the evidence base for the prevention of at least one form of CAN and at least one additional ACE outside of indictors of CAN. Applicants should describe what is already known about the approach, including but not limited to a rigorous examination of health equity implications.

Considerations Regarding NOFO Scope: The goal of this research announcement is to support rigorous evaluations to strengthen the evidence base on the effectiveness of community- and societal approaches for the primary prevention of ACEs. Public health strategies are often characterized in terms of the timing of prevention: primary prevention approaches, which focus on preventing violence before it occurs; secondary prevention approaches, which focus on the more immediate responses to recent violence, such as victim treatment or services; and tertiary prevention approaches, which focus on long-term care after violence has occurred, such as rehabilitation/reintegration, attempts to lessen trauma or reduce the long-term disability associated with violence. Research funded under this announcement is intended to focus on evaluation of primary prevention approaches.

Applicants must propose rigorous quantitative evaluation designs, which for the purpose of this funding opportunity can include those that utilize experimental designs (i.e., randomized controlled trials) or quasi-experimental designs (e.g., comparative interrupted time series design, difference-in-difference with multiple time periods, instrumental variables, regression discontinuity, regression point displacement, stepped wedge, propensity score matching, comparison groups, etc.). Applicants are encouraged to also include a qualitative component to support the rigorous quantitative evaluation. If proposing to augment the rigorous quantitative evaluation with qualitative or mixed methods, applications should describe appropriate qualitative analysis methods.

Applicants are required to evaluate an existing policy or program that has not yet been rigorously evaluated and is not currently undergoing a rigorous outcome evaluation for its impact on ACEs. However, policies and programs that have evidence that they prevent and reduce one ACE but have not yet been rigorously evaluated for additional ACEs may be considered. This may include policies and programs that have been evaluated for one form of CAN, but not other forms (for example, policies and programs evaluated and found effective for reducing child physical abuse but not yet rigorously evaluated for it impacts on emotional or physical neglect). Applications proposing to evaluate such approaches must describe how the proposed research would add to the evidence base for the prevention of a broader range of ACEs and advance what is already known about the approach, including but not limited to a rigorous examination of health equity implications.

References

Anderson, N. W., Eisenberg, D., & Zimmerman, F. J. (2023). Structural Racism and Well-Being Among Young People in the US. American Journal of Preventive Medicine, 65(6), 1078-1091. https://doi.org/10.1016/j.amepre.2023.06.017

Austin, A., Herrick, H., Proescholdbell, S., & Simmons, J. (2016). Disability and exposure to high levels of adverse childhood experiences: Effect on health and risk behavior. North Carolina Medical Journal, 77(1), 30–36.

https://www.researchgate.net/profile/Scott- Proescholdbell/publication/290453159_Disability_and_Exposure_to_High_Levels_of_ Adverse_Childhood_Experiences_Effect_on_Health_and_Risk_Behavior/links/56a663 7508ae01892ceeaf0b/Disability-and-Exposure-to-High-Levels-of-Adverse-Childhood- Experiences-Effect-on-Health-and-Risk-Behavior.pdf

Austin, A., Herrick, H., Proescholdbell, S., & Simmons, J. (2016). Disability and exposure to high levels of adverse childhood experiences: Effect on health and risk behavior. North Carolina Medical Journal, 77(1), 30–36. https://doi.org/ 10.18043/ncm.77.1.30

Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.

Journal of personality and social psychology, 51(6), 1173.

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