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The Adverse Childhood Experiences (ACEs) Public-Private Initiative (APPI) evaluation is a retrospective mixed-methods study designed to answer a central question: “Can a multifaceted, scalable, community-based empowerment strategy focused on mitigating or preventing ACEs succeed in producing a wide array of positive outcomes in a community, including reduction of child maltreatment and improvement of child and youth development outcomes?” The five APPI sites are located outside Seattle in counties characterized by small core cities surrounded by rural areas, bounded by significant geographic features. All five APPI sites have comparatively large ethnic populations. During the past 10 years, the five sites have focused on the complex problem of childhood trauma, and have developed strong, collaborative partner networks that have initiated change at multiple levels across multiple sectors. However, economic realities and political dynamics affected the sites’ access to funding and policy advocacy efforts.

This cross-site interim report describes the development, theory of change, and current activities of the five sites. The report also summarizes the state- and county-level trends in ACEs and resilience-related risk and protective factors.