Family Resilience Initiative – FY23

Overview

Childhood ACEs. We propose study of the genesis, modifying factors, and outcomes related to ACEs in Memphis children. Children with significant ACEs and other social determinants of health (SDH) needs will be identified in primary care practices and trauma-informed programs at Le Bonheur (initially in the resident continuity clinic with planned expansion into Le Bonheur Pediatrics clinic sites in the community). These children will be given access to a new program termed the Family Resilience Initiative (FRI) based at Le Bonheur offering comprehensive assessment, home visits, education, treatment (e.g., psychotherapy), and wellness training. These services will be evidence-based and trauma-informed. Together with existing cohorts such as CHAMP, the Healthy Lifestyles Clinic, and CANDLE, this Program will also serve as platform for research at several levels. Because we need to integrate scientific efforts at the population level as well as to the biological and clinical levels, we will use Big Data through a knowledge-driven, evidence-based comprehensive analytic framework to study the causes of ACEs and their impacts in our community on health (e.g., asthma, obesity, mental health, substance use disorders) education (e.g. educational attainment, graduation rates) and social outcomes (e.g., household dysfunction, placement in foster care, involvement with the justice system). We will specifically evaluate the impact of exposure to environmental factors as modifiers of ACEs 18-4300 Family Resilience Initiative PI: McCullers, Jonathan Page: 4 of 5 through assessment of genetic vulnerability and exposures such as metal toxicants and organic pollutants and determine the epigenetic changes that result. We will also study the impact of interventions, including health/government policy and provision of health services, and changes to the built environment, on outcomes related to ACEs. This Program will interface with and augment related programs such as the Pediatric Obesity Program and the Childhood Asthma Program through investigations to determine the social and biologic basis of health outcomes including these important chronic diseases of poverty. The program has now largely been established and will serve its first patients in March of 2018.