# HOPE Summit

> **NIH NIH R13** · TUFTS MEDICAL CENTER · 2021 · $48,000

## Abstract

Experiences, both positive and negative, affect adult health outcomes. As our Healthy Outcomes from Positive
Experiences (HOPE) framework has shown, considering research evidence on the role of positive experiences
in child development allows for the development of a family-centered, strength-based, and anti-racist approach
to working with families. Adverse childhood experiences (ACEs) are linked to poor adult mental and physical
health outcomes. ACEs have been implicated in the development of toxic stress, which presents a biologic
explanation for the worse health outcomes seen in adults who report having ACEs. Positive childhood
experiences (PCEs) also affect long-term adult health. In a recent study, seven questions concerning specific
PCEs were added to the Wisconsin Behavioral Risk Factor Surveillance System (BRFSS) survey. There was
a dose-response association between the number of PCEs reported and likelihood of adult depression or poor
mental health, regardless of the number of ACEs an individual recounted, demonstrating that PCEs can
prevent and mitigate the effects of ACES and toxic stress. The HOPE framework offers a novel approach to
trauma-informed care (TIC), based on including PCEs in all phases of care. HOPE is centered on four building
blocks: relationships with adults and other children; safe, stable and equitable environments to live, learn and
play; social/civic engagement; and opportunities for social/emotional development. The HOPE framework
builds on the existing risk-based based paradigm of screening, assessment, and referral by adding
consideration of specific PCEs that promote optimal development and resilience. In practice, HOPE promotes
a relationship-based approach which transforms interactions between providers and parents, focuses on a
family's assets and strengths, and upholds family agency and expertise, leading to an alignment of the
agency's goals and family's priorities. Assessments and interventions based on HOPE resist a top-down
labeling of families as broken, highlight the systemic nature of certain problems, and value shared power in
decision-making, bringing an inherently anti-racist viewpoint into practice. This framework provides a balanced
approach to assessment, workflow, and interventions that may help prevent ACEs, break the link between
ACEs and toxic stress, and improve health outcomes. The HOPE National Resource Center supports national
adoption of the HOPE framework in clinical and community-based settings through a training, technical
assistance, translational research, and evaluation. This proposed summit will support the growing momentum
for a shift in perspective from one that solely emphasizes risks and problems, to one that actively seeks out
strengths, celebrates successes, creates opportunities for positive experiences, and addresses issues of
equity and marginalization that arise from exclusively top-down, risk-based approaches to care, which blame
individuals for systemic oppressions. ...

## Key facts

- **NIH application ID:** 10247207
- **Project number:** 1R13HD105467-01
- **Recipient organization:** TUFTS MEDICAL CENTER
- **Principal Investigator:** ROBERT D SEGE
- **Activity code:** R13 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $48,000
- **Award type:** 1
- **Project period:** 2021-08-04 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10247207

## Citation

> US National Institutes of Health, RePORTER application 10247207, HOPE Summit (1R13HD105467-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10247207. Licensed CC0.

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