{"id":{"repo_id":"cambridge","oai_identifier":"oai:www.repository.cam.ac.uk:1810/386070"},"canonical_url":"https://search.dev.ndltd.org/etd/cambridge/oai:www.repository.cam.ac.uk:1810/386070","repository":{"repo_id":"cambridge","name":"Cambridge University","base_url":"https://api.repository.cam.ac.uk/server/oai/request"},"display":{"title":"Holding pieces of the same puzzle: using an understanding of the prevalence and impact of adverse childhood experiences (ACEs) to target mental health resources","abstract":"Introduction: Adverse childhood experiences (ACEs) are known to be associated with poor mental health outcomes. This thesis seeks to understand the extent to which different ACEs can be measured using routinely-collected data, and what early interventions might be indicated to support the mental health of young people who experience them. Methods: The thesis comprises a rapid literature review and survey of experts to understand mental health risk factors, measurement of ACEs in a databank of routinely-collected linked data from young people, and an umbrella review of prevention and early intervention strategies to support young people’s mental health following exposure to ACEs. Results: In brief, the three studies demonstrate that: 1) experts believe ACEs are important risk factors for predicting mental health problems earlier in young people; 2) some, though not all types of ACEs can to a variable extent be measured in routinely-collected linked health and social care data, yet this is currently a time-intensive and costly process, with various limitations including the crucial fact that it clearly misses many cases of ACEs; and 3) there is evidence supporting that early interventions are effective for mitigating poor mental health outcomes following exposure to certain ACEs. Conclusions: Measurement of ACEs using routine data sources is a potential mechanism by which young people could be identified and offered earlier interventions for those who need them. There remains a long way to go before this could be a routine practice and, at present, measurement of ACEs would need to be heavily supplemented by other approaches to ensure measurement gaps are addressed. However, ACE-informed decision-making and resource allocation could be a valuable approach to explore in order to proactively support the mental health of young people, shifting the dial away from late treatment and towards timely and proportionate prevention and support.","abstract_html":"Introduction: Adverse childhood experiences (ACEs) are known to be associated with poor mental health outcomes. This thesis seeks to understand the extent to which different ACEs can be measured using routinely-collected data, and what early interventions might be indicated to support the mental health of young people who experience them. Methods: The thesis comprises a rapid literature review and survey of experts to understand mental health risk factors, measurement of ACEs in a databank of routinely-collected linked data from young people, and an umbrella review of prevention and early intervention strategies to support young people’s mental health following exposure to ACEs. Results: In brief, the three studies demonstrate that: 1) experts believe ACEs are important risk factors for predicting mental health problems earlier in young people; 2) some, though not all types of ACEs can to a variable extent be measured in routinely-collected linked health and social care data, yet this is currently a time-intensive and costly process, with various limitations including the crucial fact that it clearly misses many cases of ACEs; and 3) there is evidence supporting that early interventions are effective for mitigating poor mental health outcomes following exposure to certain ACEs. Conclusions: Measurement of ACEs using routine data sources is a potential mechanism by which young people could be identified and offered earlier interventions for those who need them. There remains a long way to go before this could be a routine practice and, at present, measurement of ACEs would need to be heavily supplemented by other approaches to ensure measurement gaps are addressed. However, ACE-informed decision-making and resource allocation could be a valuable approach to explore in order to proactively support the mental health of young people, shifting the dial away from late treatment and towards timely and proportionate prevention and support.","abstract_has_math":false,"creators":["Parkin, Katherine"],"institution":"University of Cambridge","degree_name":"Doctor of Philosophy (PhD)","degree_level":"Doctoral","degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Brayne, Carol","Moore, Anna"],"committee_chairs":[],"committee_members":[],"year":2024,"date_issued":"2024-09-30","date_published":"2024-09-30","updated_at":"2026-07-22T22:24:24Z","subjects":["adverse childhood experiences (ACEs)","children and young people","data linkage","early identification","early intervention","mental health","routinely-collected data"],"languages":[],"rights":[],"rights_urls":["https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/834edeb6-e360-4cd3-b8bf-0b25268e4025/download","https://creativecommons.org/licenses/by/4.0/"],"identifier_entries":[{"key":"dc:creator.authoridentifier","label":"Author Identifier","values":["0000000173385667"],"render_values":[{"text":"0000-0001-7338-5667","href":"https://orcid.org/0000-0001-7338-5667","code":true}]}]},"links":{"outbound_url":"https://doi.org/10.17863/CAM.119444","outbound_label":"DOI","outbound_source":"dc:identifier.doi"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Brayne, Carol","Moore, Anna"]},{"key":"dc:contributor.sponsor","label":"Sponsor","values":["PhD co-funders: NIHR School for Public Health Research (NIHR SPHR); NIHR Applied Research Collaboration East of England (NIHR ARC EoE) Additional project-specific funders: What Works for Children's Social Care (WWCSC); Cambridgeshire and Peterborough NHS Foundation Trust (CPFT); Medical Research Council (MRC)"]},{"key":"dc:creator","label":"Author","values":["Parkin, Katherine"]},{"key":"dc:creator.authoridentifier","label":"Author Identifier","values":["0000000173385667"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.issued","label":"Date","values":["2024-09-30"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cambridge"]},{"key":"dc:relation.isreferencedby.uri","label":"Dc Relation Isreferencedby URI","values":["https://www.repository.cam.ac.uk/handle/1810/386070"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Doctoral"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["Doctor of Philosophy (PhD)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["adverse childhood experiences (ACEs)","children and young people","data linkage","early identification","early intervention","mental health","routinely-collected data"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/834edeb6-e360-4cd3-b8bf-0b25268e4025/download","https://creativecommons.org/licenses/by/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.doi","label":"DOI","values":["https://doi.org/10.17863/CAM.119444"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/e1fe7168-4179-462e-ab68-b3539d81ce12/download"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Introduction: Adverse childhood experiences (ACEs) are known to be associated with poor mental health outcomes. This thesis seeks to understand the extent to which different ACEs can be measured using routinely-collected data, and what early interventions might be indicated to support the mental health of young people who experience them. Methods: The thesis comprises a rapid literature review and survey of experts to understand mental health risk factors, measurement of ACEs in a databank of routinely-collected linked data from young people, and an umbrella review of prevention and early intervention strategies to support young people’s mental health following exposure to ACEs. Results: In brief, the three studies demonstrate that: 1) experts believe ACEs are important risk factors for predicting mental health problems earlier in young people; 2) some, though not all types of ACEs can to a variable extent be measured in routinely-collected linked health and social care data, yet this is currently a time-intensive and costly process, with various limitations including the crucial fact that it clearly misses many cases of ACEs; and 3) there is evidence supporting that early interventions are effective for mitigating poor mental health outcomes following exposure to certain ACEs. Conclusions: Measurement of ACEs using routine data sources is a potential mechanism by which young people could be identified and offered earlier interventions for those who need them. There remains a long way to go before this could be a routine practice and, at present, measurement of ACEs would need to be heavily supplemented by other approaches to ensure measurement gaps are addressed. However, ACE-informed decision-making and resource allocation could be a valuable approach to explore in order to proactively support the mental health of young people, shifting the dial away from late treatment and towards timely and proportionate prevention and support."]},{"key":"dc:format.checksum.md5","label":"Dc Format Checksum Md5","values":["4c08fc5d2173cf6a555977ccf15850a1","87eda9de84448d1f82354d60eee3eb5f"]},{"key":"dc:title","label":"Title","values":["Holding pieces of the same puzzle: using an understanding of the prevalence and impact of adverse childhood experiences (ACEs) to target mental health resources"]}]}],"canonical_facts":{"dc:contributor.advisor":["Brayne, Carol","Moore, Anna"],"dc:contributor.sponsor":["PhD co-funders: NIHR School for Public Health Research (NIHR SPHR); NIHR Applied Research Collaboration East of England (NIHR ARC EoE) Additional project-specific funders: What Works for Children's Social Care (WWCSC); Cambridgeshire and Peterborough NHS Foundation Trust (CPFT); Medical Research Council (MRC)"],"dc:creator":["Parkin, Katherine"],"dc:creator.authoridentifier":["0000000173385667"],"dc:date.issued":["2024-09-30"],"dc:description.abstract":["Introduction: Adverse childhood experiences (ACEs) are known to be associated with poor mental health outcomes. This thesis seeks to understand the extent to which different ACEs can be measured using routinely-collected data, and what early interventions might be indicated to support the mental health of young people who experience them. Methods: The thesis comprises a rapid literature review and survey of experts to understand mental health risk factors, measurement of ACEs in a databank of routinely-collected linked data from young people, and an umbrella review of prevention and early intervention strategies to support young people’s mental health following exposure to ACEs. Results: In brief, the three studies demonstrate that: 1) experts believe ACEs are important risk factors for predicting mental health problems earlier in young people; 2) some, though not all types of ACEs can to a variable extent be measured in routinely-collected linked health and social care data, yet this is currently a time-intensive and costly process, with various limitations including the crucial fact that it clearly misses many cases of ACEs; and 3) there is evidence supporting that early interventions are effective for mitigating poor mental health outcomes following exposure to certain ACEs. Conclusions: Measurement of ACEs using routine data sources is a potential mechanism by which young people could be identified and offered earlier interventions for those who need them. There remains a long way to go before this could be a routine practice and, at present, measurement of ACEs would need to be heavily supplemented by other approaches to ensure measurement gaps are addressed. However, ACE-informed decision-making and resource allocation could be a valuable approach to explore in order to proactively support the mental health of young people, shifting the dial away from late treatment and towards timely and proportionate prevention and support."],"dc:format.checksum.md5":["4c08fc5d2173cf6a555977ccf15850a1","87eda9de84448d1f82354d60eee3eb5f"],"dc:identifier.doi":["https://doi.org/10.17863/CAM.119444"],"dc:identifier.uri":["https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/e1fe7168-4179-462e-ab68-b3539d81ce12/download"],"dc:publisher.institution":["University of Cambridge"],"dc:relation.isreferencedby.uri":["https://www.repository.cam.ac.uk/handle/1810/386070"],"dc:rights":["https://apollo8-f-pro.lib.cam.ac.uk/bitstreams/834edeb6-e360-4cd3-b8bf-0b25268e4025/download","https://creativecommons.org/licenses/by/4.0/"],"dc:subject":["adverse childhood experiences (ACEs)","children and young people","data linkage","early identification","early intervention","mental health","routinely-collected data"],"dc:title":["Holding pieces of the same puzzle: using an understanding of the prevalence and impact of adverse childhood experiences (ACEs) to target mental health resources"],"dc:type":["Thesis"],"dc:type.qualificationlevel":["Doctoral"],"dc:type.qualificationname":["Doctor of Philosophy (PhD)"]},"updated_at":"2026-07-22T22:24:24Z"}