Evaluation of "Live Beyond": A Public Awareness Campaign to Address Adverse Childhood Experiences and Toxic Stress in California.

Abstract

Adverse childhood experiences (ACEs) are potentially traumatic events, such as abuse, neglect, and household stress, that occur before the age of 18. ACEs are common: Almost two-thirds of U.S. adults report at least one ACE, and nearly one-fifth report four or more. ACEs can have wide-ranging effects on mental and physical health and social relationships. These negative health outcomes come about through a process known as toxic stress, a condition characterized by heightened and prolonged physiological and psychological changes that can persist into adulthood. Given the substantial cost of ACEs to society and their potential to affect future generations, broad population-level interventions are needed. For this study, the authors evaluated Live Beyond, a public awareness campaign funded by the Office of the California Surgeon General and carried out by Civilian, a social marketing and communications agency. Civilian used social marketing to reach two priority populations: youth and young adults ages 16 to 25, and caregivers of youth ages 8 to 16 in California. The study presents findings of a process evaluation that used document review to detail the planning, development, and implementation of the campaign, and an outcome evaluation that used surveys precampaign and ten months postimplementation to examine the campaign's impact on transition-age youth's and caregivers' ACE-related knowledge and awareness, attitudes and beliefs, skills and actions, and well-being. The authors concluded that, if continued for a longer time, Live Beyond could make headway in addressing the high prevalence and cost of ACEs and toxic stress in California.