Date of Graduation

Fall 12-13-2019

Document Access

Project/Capstone - Global access

Degree Name

Master of Public Health (MPH)


School of Nursing and Health Professions

First Advisor

Dr. Kelly L'Engle

Second Advisor

Dr. Dory Escobar


Adverse childhood experiences (ACEs) are stressful or traumatic events that include abuse and neglect. These events also include household dysfunctions such as domestic violence and substance abuse disorders within a household. Other events that fall under ACEs include sexual abuse, physical abuse, emotional abuse, parental separation, intimate partner violence, etc. (SAMSHA, n.d.). Multiple studies have shown that adverse experiences that result in trauma are linked to poor long-term health outcomes. Trauma-informed care practices are essential to aiding victims in building resilience to trauma. The Road to Resilience (n.d.) defines resilience as the ability to adapt or cope with trauma, adversity, family and health problems. Trauma-informed care is a strength-based tool that is used by health professionals to help trauma survivors empower themselves and regain control over their lives (Mental Health Coordinating Council, n.d.).The purpose of this assessment was to learn how health and social service providers involved with the Sonoma County ACES Connection Coalition are implementing trauma-informed care. Six subjects participated in the study. Four individuals filled out a survey containing 10 close-ended milestone questions and 8 open-ended questions while two participated in semi-structured interviews answering the same questions. Survey results found that 17% of the participants did administer ACEs and resilience surveys to their clients while 83% did not. In the assessment, 50% percent of the participants reported that they worked in an organization that integrated policies and trauma-informed care, 33.3% did not, and 17% reported if they did or did not. Participants reported that more human resource policies need to be integrated into trauma-informed care. Others stated that trauma-informed care was not implemented in county government agencies since the current policies were strict. Participants also reported that more outcomes research was needed to evaluate the effectiveness of trauma-informed care. The ACEs screening tool was used by some organizations while others did not utilize the tool. Findings suggest that policies are needed to frame how trauma-informed care practices are implemented at the organizational level. More outcomes research should be conducted to see if trauma-informed care improves client quality of life.