Shifting Connections: Assessing Changes in a Rural Social Network Addressing Adverse Childhood Experiences Over Time.

Context: The present study was designed in the context of a movement towards using community-scale network-based approaches to address adverse childhood experiences (ACEs). Though these types of networks have become more common, assessments over time following typical network-building activities have been limited.

Objective: This study focused on the question: To what extent does a rural ACEs network improve exchanges among network members following an intervention focused on improving interactions and networking among members?

Design: We employed a pre-post design, assessing partnerships among organizations addressing ACEs within a single rural community with a baseline assessment and a follow-up assessment three years later.

Setting: The study was conducted in the rural San Luis Valley in Colorado. It was part of a larger federally-funded, community-engaged study, entitled Supporting Trauma Awareness and Nurturing Children's Environments (STANCE).

Participants: Participants for this study were representatives of organizations in the network (n = 59 in T1 and n = 58 in T2, n = 56 overlapping organizations across time points). Each participant was asked to report about their organization's partnerships in the network at two time points.

Intervention: Between the baseline and follow-up assessments, an intervention to further develop the network was implemented. It included hosting a networking event among organizations working on ACEs and the development of a subcommittee of the local interagency oversight group that focused on promoting information-sharing about early childhood and ACEs among local organizations.

Main outcome measures: Outcome measures included: clustering, path length, centrality and centralization, and density over time.

Results: We identified changes across key network metrics, indicating that the network had increased centrality and centralization over time, decreased average path length, and increased clustering and density across three sub-networks.

Conclusions: Changes identified in this network provide evidence that ACEs networks can change in response to focused network development activities.