
Understanding the current research on positive childhood experiences through the HOPE framework
The HOPE National Resource Center, with collaborators at the RAND Corporation and the Centers for Disease Control and Prevention (CDC), recently published a paper in the International Journal of Environmental Research and Public Health. This article, “Health Associations of Positive Childhood Experiences: A Scoping Review of the Literature” is a scoping review that provides a broad overview of the existing research about positive childhood experiences (PCEs) and their connection to mental, behavioral, and physical health outcomes. Scoping reviews are used to identify trends, categorize studies, and find gaps for future research.
This study focused on the impact of three of the Four Building Blocks of HOPE: relationship, environment, and engagement. For health outcomes, we looked at mental health (e.g., depression, anxiety), behavioral health (e.g., substance misuse, suicidal behaviors), physical health (e.g., cardiovascular disease, diabetes), and violence victimization or perpetration (e.g., being bullied and bullying). After screening thousands of studies using predetermined inclusion and exclusion criteria, we had 220 studies for our review.
Research showed the most commonly studied categories of PCEs
The research team broke down the Building Blocks into sub-categories and ranked them by research activity – high, moderate, or low. A high level of research activity meant that there were more studies, more robust research designs used, and larger sample sizes.
Building Block of relationships sub-categories
- Love and support from a caregiver.
- Quality relationship with a caregiver.
- Having positive peer relationships, social support.
- Support from a teacher.
- Support from a non-caregiver adult.
Building Block of environment sub-categories
- Having access to a protective school environment.
- Parental monitoring.
- Related family environments.
Building Block of engagement sub-categories
- Having opportunities for extracurricular engagement with school or with the community.
- Having beliefs that give comfort had a high level.
PCEs have an impact on our health
Finally, we found which of these sub-categories had the most evidence for impacting specific health outcomes. For the Building Block of relationship, we found the most evidence for love and support from a caregiver reducing suicidal behaviors and improving mental health outcomes. For the environment, we found that having access to a protective school environment had the most evidence for reducing substance misuse.
For health outcomes, substance misuse was the most commonly studied (305 associations across 93 studies), followed by suicidal behaviors (195 associations across 56 studies), and depression (112 associations across 55 studies). The Building Block of relationships was the most often studied (415 associations), followed by environment (236 associations), and engagement (114 associations).
The gaps in literature and where PCE research can go next
Based on the studies included in our review, we were also able to identify gaps in the published research. Only six studies investigated physical health outcomes. While there is a lot of research on depression, we found that research on other mental health issues was limited. Understanding physical health outcomes and a more diverse look at mental health outcomes is critical to study, as we know adverse childhood experiences (ACEs) negatively affect these outcomes and PCEs have significant potential to positively interfere with them.
We are excited to share this study and have it published for others to use in their own studies and to help bridge the gaps in PCE research. This study shares the importance of promoting PCEs in our work with children and families, and highlights a need for the HOPE framework.