STANCE Project


This Center project builds on our long history of partnerships in the rural San Luis Valley, state partnerships and the need for expansion to other states in HHS Region 8. The Center’s specific aims cover the required key elements and activities and are framed in five over-arching long-term areas of investigation: 1) Establish and complete a 5-year center research and translation agenda to promote family and child health and well-being, thriving communities, and health equity in the Rocky Mountain Region; 2) Develop and strengthen community partnerships to bridge research to public health practice; 3) Develop and sustain translation efforts across Colorado; 4) Communicate and disseminate findings across Colorado and Region 8; and 5) Train public health and medical practitioners, students and multisector practitioners across Colorado and Region 8.   

The public health practice-based core research project is designed to reduce the intergenerational transmission of adverse childhood experiences (ACEs) in the San Luis Valley (SLV) of Colorado, which are modifiable risk factors that have a profound and lasting effect on a person’s health. To accomplish this, a community-engaged, stakeholder-driven, multi-level intervention, entitled STANCE (Linking Systems To address ACEs iN Childhood Early on) is proposed. The STANCE intervention has three primary components: 1) Universal assessment of ACEs for all children aged zero to five and their primary caregivers, 2) Implementation of the pyramid model in early childcare education (ECE) settings to promote positive social-emotional development, and 3) a community-level social network analysis to leverage and strengthen the system of care to better meet the needs of children and families struggling with a high number of ACEs and associated downstream health outcomes. The primary effectiveness outcomes will be evaluated using a stepped wedge cluster randomized design conducted in ~15 ECE centers (~730 children). A systems change approach that marries preschools, community organizations, government agencies, policy-makers, and researchers, will increase the chances for success for vulnerable children prior to the compounding effects of health problems caused by ACEs.   

Center and research components together represent the integration of research and practice with meaningful community participation which will lead to results that are responsive to local public health needs while promoting templates of community-engaged research also relevant for other settings. Through active collaboration, we will build local capacity to execute evidence-based public health practice.