Giving children a stronger start: Qualitative insights from first 5 California's campaign to address adverse childhood experiences and toxic stress

There is a high prevalence of Adverse Childhood Experiences (ACEs) and toxic stress response (TSR) in California. ACEs can lead to negative long-term outcomes and intergenerational transmission therefore parent and caregiver education is paramount. Stronger Starts is the first media campaign developed to increase awareness about ACEs and TSR among parents and caregivers of young children. We conducted campaign messaging testing focus groups and interviews ( n = 42) in 2023 by showing storyboards to California parents and caregivers of children ages 0 to 5, who were experiencing low-income, and reported ACEs themselves. Storyboards featured educational messages about ACEs and TSR and how to disrupt TSR. Participants were motivated to address and learn more about TSR when messaging: employed a hopeful, nonjudgmental tone and provided actionable steps; depicted a strong parent-child connection; conveyed urgency and seriousness of TSR from a “voice of authority”; and reflected relatable, diverse families. Innovation: The Stronger Starts campaign is leading the way in trauma-informed education for parents with ACEs. Findings underscore the importance of understanding an audiences' spectrum of lived experiences in determining the most motivating and effective messaging. • “Stronger Starts” is a new media campaign aimed at increasing awareness about Adverse Childhood Experiences (ACEs) and toxic stress response (TSR) among California parents and caregivers of young children to buffer against the impact of TSR resulting from ACEs. • This study focused on testing an ACEs and TSR education media campaign messaging with California parents and caregivers of children ages 0 to 5, who were experiencing low-income, and reported ACEs themselves. • Parents and caregivers were motivated to address and learn more about toxic stress in their children when messaging: employed a hopeful, nonjudgmental tone and provided actionable steps; depicted a strong parent-child connection; conveyed the urgency and seriousness of the long-term implications of toxic stress from a “voice of authority”; and reflected relatable, diverse families. • Findings underscore the importance of understanding an audiences' spectrum of lived experiences in determining the most motivating and effective messaging.