34 - Understanding how research and scientific investments cultivate health equity science: A pilot on the prevention of adverse childhood experiences (ACEs) at CDC

Abstract Information: Health equity, according to the Centers for Disease Control and Prevention (CDC), is defined as “the state in which everyone has a fair and just opportunity to attain their highest level of health.” As health equity has increasingly been named a public health research priority, many organizations have struggled with understanding the impact and reach of that increased focus. The CDC National Center for Injury Prevention and Control (NCIPC), in collaboration with Deloitte Consulting LLP, undertook an evaluation to better understand how its research and science investments are cultivating health equity science. Additionally, this evaluation aimed to understand whether increased public health attention to health equity may be contributing to an increase in researchers’ focus on health equity. While the evaluation focused on Adverse Childhood Experiences (ACEs) research and science, the results may inform other NCIPC research priorities. The evaluation team employed a mixed-methods approach, conducting a qualitative analysis through interviews and employing both quantitative and qualitative analyses of data in NCIPC systems. These systems track intramural and extramural scientific projects that address ACEs. Interviews with individuals (n=9) working on health equity and ACEs across NCIPC served as a critical first step to understand the needs of the end users of the evaluation results and inform the evaluation design. The evaluation team then extracted data from four NCIPC systems and reviewed all records from 2018-2024 related to ACEs to categorize by health equity focus area and identify populations of focus and promising practices related to health equity. The evaluation team validated and contextualized findings from the systems analysis using discussions with NCIPC ACEs staff. Findings from the initial interviews suggest that research and science investments have strengthened the field’s understanding of existing disparities and inequities. However, there is a need to translate the knowledge of disparities and inequities into effective interventions that reduce disparities in ACEs. The initial interviews also showed an increased need to work with community partners to develop infrastructure for evaluation and address structural and systemic inequities that drive disparities in ACEs. Additional findings from the systems analysis will be shared as part of this discussion. NCIPC plans to use evaluation results to inform its research priority setting practices, adjust processes to fill gaps in ACEs science, guide implementation science efforts, and socialize promising practices for health equity approaches with external and internal audiences.