All ETDs from UAB

Advisory Committee Chair

Retta R Evans

Advisory Committee Members

Dione Moultrie King

Lindsay Leban

David M Macrina

Larrell L Wilkinson

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Education


Adverse childhood experiences (ACEs) have a well-established relationship with poorer mental health, health, and school-related outcomes among children. ACEs researchers have identified potential resilience frameworks like the National Scientific Council on the Developing Child (NSCDC), Health Outcomes from Positive Experiences (HOPE), and cumulative positive childhood experiences (PCEs) frameworks that identify protective factors to mitigate ACEs. However, each framework has a limited evidence base with no known studies comparing their effectiveness. The purpose of this dissertation was to compare the relationship between these three resilience frameworks and childhood outcomes in three domains (mental health, weight status, and school-related outcomes) among children who experienced ACEs utilizing a preprint/reprint format in which each study examined a different domain. For all three studies, secondary data analysis was conducted using the 2018-2020 National Survey for Children’s Health. The first study found that the NSCDC and HOPE frameworks were associated with childhood mental health, but the NSCDC framework had a stronger relationship. The second study found that the NSCDC and HOPE frameworks were also associated with childhood obesity with the HOPE framework explaining a similar or slightly more variance in childhood obesity than the NSCDC framework. In the final study, the NSCDC and HOPE frameworks were associated with school engagement, excessive absenteeism, and grade retention, but the NSCDC framework had a stronger relationship with all three outcomes. Across all three studies, the cumulative PCE framework either did not practically or significantly improve any of the regression models. Most outcomes were consistent after controlling for ACEs and across ACEs subgroups. Across analyses, self-regulation, mastery, and a supportive parent/caregiver relationship were the strongest NSCDC framework protective factors for most outcomes. After-school activities and sharing ideas were typically the strongest HOPE framework protective factors across outcomes. Other protective factors from both frameworks were associated with specific outcomes. These findings were consistent after controlling for ACEs and across most ACEs subgroups. While additional research is needed to validate and expand on these findings, the NSCDC and HOPE frameworks are promising resilience frameworks that could be integrated into future interventions to improve outcomes among children who experienced ACEs.

Included in

Education Commons