Implementing a Narrative Change Intervention to Address ACEs and Prevent Future Substance Abuse

About the Program

The National Network of Public Health Institutes and the Michigan Public Health Institute, in collaboration with the Centers for Disease Control and Prevention, local health departments, community power-building organizations, and Vanderbilt University implemented a three-year initiative to prevent future substance use in three midwestern communities by addressing Adverse Childhood Experiences (ACEs) through a narrative change strategy. To build support for changing the conditions in which children and families live, community organizers, public health practitioners, and their partners implemented a narrative change process as a key strategy. This approach involved a two-day, in-person workshop to assist stakeholders to create a shared, values-based narrative which was then implemented within their community networks to increase support for addressing conditions that contribute to ACEs with the end of preventing substance use disorders in their communities.

Examples of narrative change activities from participating project partners:

• Our Stories. Our Healing Video Podcast Series: The Cuyahoga County Board of Health, A Vision of Change, Creating Greater Destinies, and the ADAMHS Board teamed up to launch this video series titled Our Stories, Our Healing. This series aims to raise awareness through storytelling by community members who have overcome traumas and found healing. Mental health, substance use disorders, and domestic violence are a few of the topics that will be explored throughout the series.

Additional Resources

• The Narrative Initiative- https://narrativeinitiative.org/
• CDC’s ACEs Resources Page- https://www.cdc.gov/violenceprevention/aces/index.html
• World Health Organization’s A Conceptual Framework for Action on the Social Determinants of Health (who.int)

Partner Websites

• Cayuhoga County Board of Health
• Detroit Health Department | City of Detroit (detroitmi.gov)
• Health Department – Health (cincinnati-oh.gov)
• Ohio Organizing Collaborative (ohorganizing.org)
• Health | A Vision of Change | United States
• ADAMHS Board of Cuyahoga County | Home (adamhscc.org)
• Home – Hamilton County Public Health | Hamilton County Public Health (hamiltoncountyhealth.org)
• MOSES

Transforming the Narrative: Health Equity & The Community – A Video Training and Workbook

This video training will help you get started on understanding narrative, the power of narrative, co-creating an aspirational or transformative narrative and integrating it into your work to achieve health equity in your community. This is group work, not to be done in isolation. Community does not happen in a silo. Neither does co-creating an aspirational narrative or building power for healthy communities.

The training is divided into sections, many of which include group activities to deepen relationships and understandings and to begin to strategize about narrative change work. Throughout the video, you will hear from participants in the ACEs narrative change project.

Video Training Worksheets

Video Training

Transforming the Narrative: Health Equity & The Community – A Toolkit

In response to the need for more tools and trainings around narrative change, this toolkit was designed, not as a step-by-step guide to narrative change, but to complement the narrative change work being done in our communities every day that decrease exposure to ACEs that will eventually prevent substance use, and in the process help create more opportunities to achieve health equity. The goal of this toolkit is to offer insight from project partners that built and amplified transformative narratives in their communities, as well as resources that will help others build sustainable, cross-sector relationships, and harness grassroots power that helps us all to get closer in achieving  health equity in our communities. For health departments and their partners, the toolkit offers a frame to develop more justice-rooted language.

We recommend using the toolkit in collaboration with the video training. The workbook is located at the end of the toolkit. When choosing to engage in narrative change work we ask you to be curious about yourself and the others you are inviting in. Know that this work is powerful and that we all have biases and stories that impact how and why we interact with our families, communities, and organizations the way we do. When we say “yes” to working together we learn how to listen more intently and get clear about the changes we see as integral to evolution.

Funding for this publication was provided to the National Network of Public Health Institutes (NNPHI) through a Cooperative Agreement with the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (CDC – 6 NU1ROT000016-01-02) totaling $2,900,000.