100% New Mexico Initiative

100% POWER HOUR

ONE: ENGAGE

PLEASE NOTE: This page contains supplemental information for attendees of the 7-part 100% New Mexico initiative power hours. Attendance is free, but registration is required. Please register here.

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We are providing the slides and narrative text used in the 100% Power Hour: Engaging in Change being offered quarterly by the Anna, Age Eight Institute. The 7-part webinar series is designed to give 100% New Mexico initiative members an overview of key concepts and issues related to implementing the initiative in their county. Currently nine counties are engaged in the initiative.

Power Hour participants are encouraged to use this page for local presentations in order to increase public awareness of adverse childhood experiences (ACEs), trauma, social adversity and the data-driven prevention strategies.

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Before we begin our presentation, we want to allow for a moment of quiet reflection. Please take a minute to perform the self-care of your choice.

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PART ONE: HOW DID THE INITIATIVE START?

The 100% New Mexico initiative is a groundbreaking strategy designed to prevent adverse childhood experiences (ACEs), trauma, social adversity and promote family health, safety and resilience. The conceptual framework began development in 2015 with research that evolved into two books and an institute.

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The initiative is the centerpiece of the Anna, Age Eight Institute’s programming. It was developed by institute co-directors Katherine Ortega Courtney, PhD and Dominic Cappello who are the co-authors of Anna, Age Eight and 100% Community.

Anna, Age Eight: The data-driven prevention of childhood trauma and maltreatment guides communities in addressing epidemic rates of adverse childhood experiences (ACEs) that occur in the home and social adversity that families face outside their door.

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100% Community: Ensuring 10 vital services for surviving and thriving is the blueprint that 100% New Mexico initiative participants are using to assess barriers to vital services and build a countywide system of care that includes timely access to vital services.

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The 100% Power Hour 7-part webinar series was developed to provide initiative participants with an overview of key concepts that guide the initiative. These include the four-phase process of continuous quality improvement: assess, plan, act and evaluate.

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As we begin, we wish to point out three of the most common comments we hear as we discuss the initiative. Some local government representatives will say, “We are already doing this.” Our response is, “Wonderful. Please tell us more.” State and local agency representatives often say, “We refer families to services.” We ask how do you know services exist?” And advocates may say, “We need to get started now.” We agree.

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The goal of the data-driven, county-based and technology-fueled initiative is to empower local stakeholders in ensuring ten vital services for surviving and thriving, all key components of a county and city committed to health equity and racial justice.

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The learning objectives of 100% Power Hour #1: Engaging in Change are participants completing the webinar will be able to describe an overview of: The 100% New Mexico initiative, Adverse Childhood Experiences (ACE), social adversity, the costs of ACEs and adversity, the social determinants of health, the social-ecological model and the initiative’s framework for change.

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The 100% Power Hour process is designed to create a vehicle for building awareness of the initiative and serve as a catalyst for ongoing local community dialogue. The presentation design follows the “teach the teacher” format, developed to allow participants to provide the presentation to their initiative members and local stakeholders. To create an environment for community dialogue, we offer simple guidelines.

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We acknowledge the contribution of all initiative members across the state who have been part of the iterative process of developing the initiative to meet the unique needs of rural and urban families, as well as those serving culturally and economically diverse populations in the south and west. We also are grateful to the state and local lawmakers who have supported the initiative.

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This presentation takes place amid the COVID-19 pandemic and we pause to present an update on progress made with the vaccine implementation and delivery of medical care services for individuals and families across all 33 counties.

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REFLECTION QUESTION: Before moving on, take a few moments to reflect on what brought you to engage with the 100% New Mexico initiative. Identify any key question or concerns that you would like addressed in the presentation or in a follow-up dialogue with Institute staff.

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PART TWO: WHAT ARE ACES?

Engaging in change, within the context of the 100% New Mexico initiative, means joining a process of innovation. One becomes a change agent, using a collaborative and data-driven approach to ensure that 100% of a county’s families have the services shown to increase health, safety and resilience. We are focused on preventing adverse childhood experiences (ACEs).

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Part Two begins with identifying the long-standing and costly challenge called ACEs. First identified in The ACEs Study by Doctors Felitti and Anda in 1998, the ten forms of adversity endured in the home have harmed the lives of children and parents as well as impacting schools and the workplace. ACEs include: physical abuse, emotional abuse, sexual abuse, physical neglect, emotional neglect, living in households where parents are misusing substance, are engaged in domestic violence, adults have untreated mental health challenges, parents are separated or divorces or a household member is incarcerated.

While the ACEs ten question survey was designed to assess an adult’s level of ACEs, it is now used in health care settings by providers to assess the level of ACEs among children and youth. ACEs represent ten distinct forms of potential adversity in the home, each with its own area of research.

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ACEs and the potential trauma it can cause are far from a “private family matter.” The physical, emotional and economic consequences are significant and impact entire communities, as well as city, county and state budgets. ACEs lead to costly interventions (including law enforcement, child welfare, the courts and ER services), all with financial costs to taxpayers.

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Connecting ACEs to Support

ACTIVITY: We provide you with five stories about children and ACEs. While fictional, they are based on real children’s lives. Our activity is designed to identify which of the ten vital services for surviving and thriving can not only address each child’s ACEs, but have the capacity to prevent ACEs. The activity also explores the availability of services in your county. Download the PDF.

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REFLECTION QUESTION: How would you describe, based on personal experience, the local awareness of ACEs and their costly consequences in your county? To what degree have your local elected leaders been briefed on ACEs and their impact on life in the city and across the county?

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PART THREE: WHAT IS SOCIAL ADVERSITY?

We continue with an introduction to the concept of social adversity. These are the challenges a family member faces when leaving the home. A child may score a 0 on the ACEs survey yet face extreme hardship outside the home. A child enduring ACEs may have their lives made even more difficult in a challenging community environment.

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Social adversity can include: barriers to ten vital services for surviving and thriving (including timely health care and fully-resourced community schools); historical trauma, racism and discrimination; lack of access to the internet and it’s many services and supports; and lack of good paying jobs with benefits.

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In public health, the term “years of life lost” is used to calculate how many years an injury or illness impact one’s length of life. For example, a person dying in a car crash at age 20 may “lose” a projected 55 years, assuming an average lifespan of 75. With ACEs and social adversity, we ask: how many years of healthy childhood our children are losing?

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We know that ACEs and social adversity can impact a student’s capacity to learn. Students with high rates of ACEs may be thinking far more about what dangers await them at home, instead of math tests. We can ask: how many years of productive schooling are being lost?

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The research on ACEs and their consequences including substance use disorders and mental health challenges, reveal problems in the workplace with worker absenteeism and workers showing up unprepared to function effectively. The question in each county is: how many years of productive work are lost?

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Finally, due to all the health challenges related to ACEs and social adversity, including injury and illness related to substance disorders and mental illness, we can begin to understand the loss of life by asking: how many lives are cut short?

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REFLECTION QUESTION: How might your initiative begin to explore the cost of ACEs and social adversity to your county’s residents?

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PART FOUR: WHAT IS OUR STRATEGY?

The 100% New Mexico initiative provides another way forward, away from the emotional and financial costs associated with ACEs and social adversity. It is a first-of-its-kind strategy, mobilizing an entire county around ensuring ten vital services for 100% of residents. For those who say the vision is too big, we say anything less than 100% leaves kids behind. We are not OK with that.

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Our initiative is guided by research focused on the social determinants of health. This is a field of study that focuses on how one’s community environment and access to quality service impacts a person’s health, safety and capacity to connect with an effective education system leading to job readiness and satisfying employment. Essentially, our local environment, and level of health and education equity, has a huge impact on our future. Research on health equity and racial equity provide insights in the arena of social determinants of health. Each of our ten vital sectors has a wealth of research behind it.

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Our initiative is also guided by the social-ecological model. This is a model, with robust research behind it, used widely in public health and other fields associated with change. It is a framework that can guide local initiatives, developing strategies to support change on the individual, relationship (or family), community and societal levels.

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The 100% New Mexico is guided by a framework for change. We illustrate this process to provide all initiative members with a shared understanding of the process of change on the county level.

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[A] CHALLENGE: We begin with our 100% New Mexico county-wide survey of parents and youth to identify local challenges and barriers to vital services.

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[B] TEAM: Local champions then mobilize and create a local team, including a variety of task forces and ten action teams. Training builds the capacity of each initiative member.

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[C] KEY ELEMENTS: The local initiative commits to a shared vision and other components of the Collective Impact framework.

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[D] PROCESS: Each of the ten action teams (each one focused on removing barriers to one of the ten vital services for surviving and thriving) begins a process of continuous quality improvement (CQI). In this data-driven process, action teams identify the evidence-informed strategies/projects which show the most potential to remove barriers and increase access to quality services. Each team has 20-25 projects to choose from as a starting point.

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[E] ENGAGEMENT: Community engagement is a vital part of the initiative process, securing buy-in from local residents and elected officials for working to ensure vital services.

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[F] RESULTS: Our focus is on the results in our measurable process. We can evaluate if our projects are increasing access to service, as well as improving services in all ten sectors.

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[G] OUTCOMES: We work to achieve our vision and goal of 100% of families having access to the vital services, and with it increased health, safety, resilience, school achievement, job readiness and employment.

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We face a very stark choice in New Mexico and across the nation. We can either return to a “normal” that included ACEs, trauma, social adversity, barriers to vital services, school drop out, lack of job readiness and years of quality life lost. Or, we commit to designing a new “normal” — one where 100% can thrive.

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REFLECTION QUESTION: How does the “Framework for Change” reflect the local change process in your county? (Or how could it, once you start the initiative?)

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NEXT STEPS: Reflect on the presentation and your notes. Review the books and links to research provided. Reach out to colleagues, friends, family, neighbors and local elected leaders to discuss the 100% New Mexico initiative. We have designed this presentation so that it can be used with local elected officials within city and county government and school board members, agency leaders (representing the ten vital services), representatives from local higher education, faith-based and community-based organizations and your neighbors and friends.

Additional Resources

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