A Systematic Review of Prevention and Mitigation Recommendations for Adverse Childhood Experiences (ACEs)

The United States (U.S.) has identified Adverse Childhood Experiences (ACEs) as being a public health issue and a significant determinant of health. Research has consistently revealed strong empirical evidence that ACEs negatively impact youth and adult physical and mental health outcomes. ACEs have also been found to impact academic achievement, interpersonal skills, emotional regulation, and increase the likelihood of the adoption of risky behaviors (e.g., smoking, substance use, sexual risk taking). Moreover, extensive research has suggested the need for prevention and early intervention strategies to reduce the impact of ACEs throughout the life course. However, due to the wide-ranging scope of ACEs, it is necessary to identify which interventions have the strongest evidence base to reduce the implications of ACEs. This systematic literature review explores early intervention, prevention, and mitigation recommendations based on the literature on preventing or reducing the effects of ACEs. Utilizing a list of key terms, 1,009 non-duplicated articles were identified through database searches in PubMed, CINAHL, and Science Direct. One hundred, forty-two full text articles were inspected; of those, twenty-seven were included in this study. Four qualitative themes were identified: a) resilience; b) protective factors; c) trauma-informed care/trauma-informed response; and d) intergenerational trauma. Results from this study can help guide comprehensive, culturally relevant, population-based strategies to target the widespread effects of ACEs in the U.S. Keywords: intervention, prevention, mitigation, resilience, protective factors, trauma-informed, intergenerational trauma