HOPE Summit

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Experiences, both positive and negative, affect adult health outcomes. As our Healthy Outcomes from Positive Experiences (HOPE) framework has shown, considering research evidence on the role of positive experiences in child development allows for the development of a family-centered, strength-based, and anti-racist approach to working with families. Adverse childhood experiences (ACEs) are linked to poor adult mental and physical health outcomes. ACEs have been implicated in the development of toxic stress, which presents a biologic explanation for the worse health outcomes seen in adults who report having ACEs. Positive childhood experiences (PCEs) also affect long-term adult health. In a recent study, seven questions concerning specific PCEs were added to the Wisconsin Behavioral Risk Factor Surveillance System (BRFSS) survey. There was a dose-response association between the number of PCEs reported and likelihood of adult depression or poor mental health, regardless of the number of ACEs an individual recounted, demonstrating that PCEs can prevent and mitigate the effects of ACES and toxic stress. The HOPE framework offers a novel approach to trauma-informed care (TIC), based on including PCEs in all phases of care. HOPE is centered on four building blocks: relationships with adults and other children; safe, stable and equitable environments to live, learn and play; social/civic engagement; and opportunities for social/emotional development. The HOPE framework builds on the existing risk-based based paradigm of screening, assessment, and referral by adding consideration of specific PCEs that promote optimal development and resilience. In practice, HOPE promotes a relationship-based approach which transforms interactions between providers and parents, focuses on a family's assets and strengths, and upholds family agency and expertise, leading to an alignment of the agency's goals and family's priorities. Assessments and interventions based on HOPE resist a top-down labeling of families as broken, highlight the systemic nature of certain problems, and value shared power in decision-making, bringing an inherently anti-racist viewpoint into practice. This framework provides a balanced approach to assessment, workflow, and interventions that may help prevent ACEs, break the link between ACEs and toxic stress, and improve health outcomes. The HOPE National Resource Center supports national adoption of the HOPE framework in clinical and community-based settings through a training, technical assistance, translational research, and evaluation. This proposed summit will support the growing momentum for a shift in perspective from one that solely emphasizes risks and problems, to one that actively seeks out strengths, celebrates successes, creates opportunities for positive experiences, and addresses issues of equity and marginalization that arise from exclusively top-down, risk-based approaches to care, which blame individuals for systemic oppressions. The goal of the First Annual HOPE Summit: Seizing the Moment – Moving HOPE from Idea to Transformation, is to catalyze the transformation of the current care paradigm.