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Background <p>Adverse childhood experiences (ACEs) are associated with a wide range of negative health, behavioral, and developmental outcomes across the lifespan. However, many individuals demonstrate resilience, and protective factors play a critical role in buffering the effects of adversity. Yet most existing ACE measures overlook these protective experiences and rely primarily on retrospective adult self-reports. To address this gap, we developed the Child and Family Experiences Survey (CAFES), a caregiver-report tool designed to assess both adverse and protective experiences in early childhood across diverse settings.</p> Methods <p>Caregivers (<i>N</i> = 157) from two counties in New York State completed the CAFES, which assessed adverse experiences, protective factors, and social determinants of health items. Summary scores were calculated for both adverse and protective experiences. Descriptive statistics, bivariate correlations, and principal components analysis (PCA) were conducted to evaluate item performance and inform item reduction.</p> Results <p>Descriptive analyses showed a range of endorsement across items related to adverse experiences, protective factors, and social determinants of health items. Correlations within protective and adverse experience items were moderate, supporting internal consistency. PCA was conducted for protective factors and social determinants of health items, and a four-component solution emerged for each. The CAFES was refined based on results from descriptive findings and the PCA.</p> Conclusions <p>The CAFES is a novel, caregiver-report tool designed to assess both adverse and protective childhood experiences, as well as family needs. Developed through a community-engaged process, CAFES addresses key limitations in existing ACE measures by incorporating protective factors and offering applicability across clinical, educational, and research settings. Future efforts will focus on refining the tool through qualitative feedback, improving data collection processes, and ensuring cross-cultural relevance, for example among underrepresented and immigrant populations, while also integrating appropriate supports to enhance its clinical implementation.</p>

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Measuring adverse and protective experiences in early childhood: development and initial validation of the child and family experiences survey (CAFES)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月24日

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  • Ruofan Gongye,
  • Erinn B. Duprey,
  • A. Dirk Hightower,
  • Joseph P. McFall

摘要

Background

Adverse childhood experiences (ACEs) are associated with a wide range of negative health, behavioral, and developmental outcomes across the lifespan. However, many individuals demonstrate resilience, and protective factors play a critical role in buffering the effects of adversity. Yet most existing ACE measures overlook these protective experiences and rely primarily on retrospective adult self-reports. To address this gap, we developed the Child and Family Experiences Survey (CAFES), a caregiver-report tool designed to assess both adverse and protective experiences in early childhood across diverse settings.

Methods

Caregivers (N = 157) from two counties in New York State completed the CAFES, which assessed adverse experiences, protective factors, and social determinants of health items. Summary scores were calculated for both adverse and protective experiences. Descriptive statistics, bivariate correlations, and principal components analysis (PCA) were conducted to evaluate item performance and inform item reduction.

Results

Descriptive analyses showed a range of endorsement across items related to adverse experiences, protective factors, and social determinants of health items. Correlations within protective and adverse experience items were moderate, supporting internal consistency. PCA was conducted for protective factors and social determinants of health items, and a four-component solution emerged for each. The CAFES was refined based on results from descriptive findings and the PCA.

Conclusions

The CAFES is a novel, caregiver-report tool designed to assess both adverse and protective childhood experiences, as well as family needs. Developed through a community-engaged process, CAFES addresses key limitations in existing ACE measures by incorporating protective factors and offering applicability across clinical, educational, and research settings. Future efforts will focus on refining the tool through qualitative feedback, improving data collection processes, and ensuring cross-cultural relevance, for example among underrepresented and immigrant populations, while also integrating appropriate supports to enhance its clinical implementation.