1. ACE Bermuda Survey Development ACE Conference
Tara Hines, Healthcare Data Analyst
11th October 2018

2. Overview Current Research Survey Development
Preliminary Findings & Next steps

3. Purpose Review the existing literature and data available
Discuss research process and development, in Bermuda
Review preliminary findings from pilot

4. Data Available Transaction Level Data Census STEPS Survey
2018: Over 2.5 million claims, with 40 variables.
Census
STEPS Survey
Independent Organizations
SCARS

5. Filling the Gaps

6. Filling the Gaps Public Non-profit Government School QUANGO Church
Physician
QUANGO
Clinic
Charity
Teacher
Non-profit
Government
Church Leader
Public
School
QUANGO
Nurse
Church
Physician
Legal System
Hospital

7. Survey Tool Development
Bermuda Context
Census
Internal Feedback
WHO & BRFSS Validated Questions
Refusals

8. Survey Tool Development
Multiple Modalities
Confidentiality & Autonomy
Ethical Approval

9. Additional Considerations
Unique RTC trauma
Transient Population with High Immigration and Emigration Rates
Parallelity in Timing

10. Domains & Considerations
Demographics
Sex vs Gender
Race vs Ethnicity
Education
Work Status
Bermudian Childhood
Marital Status
Relationship with Parents/ Guardians and Family
Parents/ Guardians behavioral focus
Food security, drug/ alcohol use, violence or neglect exposure

11. Domains & Considerations
Relationship with Parents/ Guardians and Family
“See or hear” phrasing VS
“to YOU”

12. Domains & Considerations
Childhood Experiences
Child sexual abuse
Peer & Community Experiences
Bullying (with definition)
“See or hear” language
Current Lifestyle
NCD (Non-communicable disease)
Mental health
Acute and chronic illness
Risky behaviors

13. Deployment: Stakeholder Inclusion
Pilot Survey Deployment
National Survey Deployment
Advertising via Multiple Avenues
Online
Social Media
Facebook
WhatsApp
Radio Appearances
Word of Mouth

14. Survey Tool Informed Consent
This survey is the Adverse Childhood Experiences (ACE) Bermuda Questionnaire. This is designed to collect information from adults in Bermuda about events they experienced during the first 18 years of their lives and their lives now. The survey, as a part of the ACE study, is provided in partnership by Family Centre and the Bermuda Health Council.
We will collect information from participants throughout Bermuda. This is a pilot, now, to test the survey and data analysis. The information will be gathered via print and electronic surveys.
We will ask you questions about your age, education, employment, family background, community experiences, and your current lifestyle. The survey takes less than ten minutes. Please answer in one sitting, as your answers between pages will not be saved.
It is your right, at any time to:
- Decline to take part in the study
- Withdraw your consent at any time
- Decline to answer any questions in the interview that you do not wish to answer
Your information will be kept confidential and at no time will be record your name.
As this is a pilot, the results will be made public for limited review and inform the larger public survey distribution.
If you would like more information about the questions in this questionnaire, a print copy of this survey, or for information about mental health or physical health services related to this questionnaire, please or

15. Survey Follow Up Trigger warning Therapy links
Explanation of “negative” values and definitions

16. Preliminary Findings (Analysis)
Stratifying along race, Bermuda childhood, gender, education
Chi squared analysis
Odds ratio calculation

17. Preliminary Findings (Pilot)
Current data demonstrates higher NCD burden, especially among highly educated (defined as post- graduate completion).
Those who identified unaffordable care were more likely to have multiple co-morbidities

18. Preliminary Findings (Pilot)
More than half of respondents experienced some form of child sexual abuse
Those who have had an individual die from RTC are more likely to abide by safety recommendations
Disease recognition, regardless of education and age is difficult

19. Next Steps Full survey deployment Publication
Goal: Statistical Significance
Publication
Journal
Deployment
Screening tool development

20. Summary Current Research Survey Development
Preliminary Findings & Next steps