Future considerations for implementation and impact of community narrative initiatives

In response to communities where individuals experience both disproportionate numbers of Adverse childhood experiences (ACEs) and other health inequities, narrative change has emerged as a powerful tool to change how ACEs are viewed and addressed by communities. The special issue presents a set of papers examining efforts to use narrative change to address ACEs. In this commentary, we offer reflections on the introduction and three articles of the special issue and point to future considerations for implementation and impact of community narrative initiatives. For example, we assert that to prevent and address the outcomes of ACEs such as substance use and mental health problems, communities need to include and amplify the voices of those with lived experience during decision-making about policy. We also espouse using research models of resilience in communities as a way to further uptake of narrative change strategies in the literature on ACEs and health disparities in communities. Using trauma-informed outcomes and measures are also critical to measure how narrative change can move the needle to promote health equity.