Caregiver Perspectives on Out-of-School-Time Activities and Resource Needs Among Families With Adverse Childhood Experiences: A Cross-Sectional Survey

Organized out-of-school time activities (e.g., afterschool programs, extracurriculars) may mitigate adverse childhood experiences’ (ACEs) negative effects. Little is known about caregivers’ views on activity providers and the value, accessibility, and quality of activities for families with ACEs. To describe caregivers’ perspectives on activities and their interest in activity providers linking families to health and social-need resources, we cross-sectionally surveyed 310 caregivers of children aged 6–17 with varying caregiver and child ACE exposure in Los Angeles, CA, from December 2023 to August 2024. We described caregiver-reported activity goals, perceived family impacts, barriers, recommendations, and interest in resource connections via activity providers. Responses were compared across ACE groups (no ACEs, low ACE burden, high ACE burden), and covariate-adjusted logistic analysis examined the association between ACE burden and caregiver requests for resource assistance. Most caregivers reported health-promoting goals and perceived activity benefits, like preventing substance use and strengthening family relationships. Cost was a key barrier; expanding activity options was the top recommendation. Compared to families with zero ACEs, families with any ACEs were more likely to desire help with housing, mental health, education, employment, and finances. Families with high ACE burdens were more likely to desire assistance with mental health, parenting, housing, basic needs, trauma recovery, legal, and disability services, compared to families with zero or low ACE burdens. Families with ACEs value activities and are receptive to receiving resource support through activity providers. Lower costs, broader activity options, and stronger referral pathways may improve engagement and support families with ACE exposure.