National Pediatric Practice Community on Adverse Childhood Experiences (NPPC)


The National Pediatric Practice Community on Adverse Childhood Experiences (NPPC), an initiative of the Center for Youth Wellness, aims to enhance the overall quality of pediatric care and improve health outcomes by integrating a toxic stress framework and Adverse Childhood Experiences (ACEs) screening and intervention into pediatric medicine. This initiative is part of a national effort to transform clinical understanding and practice for children exposed to early adversity and toxic stress.

As a 3-year initiative, the NPPC has the goal of supporting 1,000 pediatric medical providers in making ACEs screening and intervention part of their routine clinical practice.

Guiding Principles

The NPPC is guided by the following principles:

  • Universal – This issue touches all pediatric practices and the goal is to equip all medical providers working with children to be able to add this practice successfully.
  • Action-oriented – We actively seek to apply the knowledge we acquire through our collaborative into practice.
  • Diverse – We acknowledge and value diversity in all its forms, including the lived experiences of practices and the children and families they serve.
  • Exponential impact – As the champions of child health, physicians have a unique and critical role to play, not only in supporting individual patient healthcare, but also in advancing the practice of medicine to make population level impact.
  • Practice informed – While the field of study on ACEs and toxic stress is nascent, the experiences and questions surface through practice are essential for advancing the research agenda in this field.


The NPPC embraces a co-designed approach that ensures that materials and training are responsive to member needs and that lessons learned as a community are disseminated widely to advance medical practice.

Collectively we will:

  1. Expand knowledge

NPPC members will receive monthly updates and quarterly webinar communications. The information shared will drawn from the identified interests and needs of the community. The NPPC will become an informational hub tools and resources relevant ACEs in medical practice.

Potential topics for communications include:

  • Emerging scientific research on ACEs and toxic stress
  • Addressing clinical barriers and challenges to ACEs screening, including lack of time, patient/provider comfort, mandated reporting issues, and referral plans
  • Training and technical support opportunities to support practices at all stages of integrating and sustaining an ACEs screening protocol
  • Information on evidence-based practices related to ACEs, toxic stress, and trauma-informed pediatric medical care
  • Patient educational and other resources
  1. Build capacity

Virtual coaching and training opportunities will allow NPPC members to learn from experts in the field and each other. These trainings will focus on building practice skills required for ACEs screening and follow up. Member will have opportunities to participate in “sub-studies” around this issue and apply to become pilot sites for individualized coaching and technical assistance.

  1. Learn collaboratively

NPPC members will be at various stages of implementation of an ACEs screening protocol and with varied experience with models that may support the optimal patient care for children and their families. Sharing our lessons learned and disseminating opportunities to advance practices will be an integral part of the NPPC offerings.

  • As part of our collective learning, we ask that all NPPC members complete a baseline assessment regarding their practice and then periodic follow up data (approximately 6 and 12 month post enrollment) so we can better understand the spectrum of comprehension, beliefs, barriers, readiness, and current clinical practice around the issues of toxic stress and ACEs. This data will be utilized to understand the landscape of the issue and to identify training and content needs and will help us ensure that the NPPC resources are responsive to member needs. Ultimately, what we create as a learning community will help inform the broader field of pediatrics as more and more physicians decide to integrate an ACEs framework into their practice.
  • Members will have access to a membership resource list, where they can find and dialogue with others in the practice community around addressing shared challenges and roadblocks, implementing screening in certain health care delivery systems or to create geographic-specific hubs.

Pilot Sites

As part of our learning about the integration of ACEs screening practices in clinical settings, we will be working with a select number of medical practices representing diverse healthcare delivery models, providing tailored support.

For our 2017 cohort, we will be working with sites that have yet to adopt an ACEs screening protocol. These sites will be facilitated through the process of adopting an ACEs screening and intervention protocol relevant to their delivery model and patient population, using a clinical quality improvement (CQI) methodology. We will be ensuring an ongoing CQI at these sites, sharing lessons learned and resources developed with these pilot sites with the broader NPPC membership.

We are currently recruiting sites who are interested in integrating ACEs screening into their practice but have yet to set up a protocol. If you are a clinic located in California interested in becoming a pilot site, please contact us for more information. Sites outside California, please stay tuned as we release more opportunities to become a pilot site in the near future.

The National Pediatric Practice Community on ACEs is led by the Center for Youth Wellness, with funding from The JPB Foundation, Genentech, Google, and the Packard Foundation.

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