173 - Community, state, and national advocacy to establish a national physical child abuse prevention day: October 4th is TEN-4 Day!

Poster Number: 173
Publication Number: 173.1091

Background: 1 in 7 children in the United States experienced abuse and neglect in the last year. 1 In 2021, there were 1,820 pediatric deaths from maltreatment with 66% of these deaths in children younger than 3 years of age. 2
Bruising is the most common and most visible sign of physical abuse. In toddlers and pre-school aged children, bruises are not uncommon, however, the location of the bruise can be helpful to distinguish accidental injuries from ones caused by physical abuse.
TEN-4-FACESp is a useful acronym to help screen children under 4 years of age with bruising to identify when a bruise is more likely to be caused by abuse than accidental injury. 3 TEN-4 Day was first held in Kentucky on October 4th, 2019 by the Face It Movement organization.

Objective: We aimed to build an advocacy strategy (targeted at physicians and child welfare professionals) to scale out TEN-4 Day and improve recognition of abuse. Our goal was to make a year-over-year increase in the number of states engaging in TEN-4 day and grow the participation to 5 states.

Design/Methods: We created a multidisciplinary leadership team that included state-level nonprofit community organizations, hospital affiliated clinicians, government relations, and media relations experts. We engaged the AAP Department of Federal Affairs and the section on State Advocacy to host a national webinar promoting TEN-4 Day. We drafted and distributed one-pager to the AAP state chapters, Pediatric Emergency listserv, and Children’s Hospital Association. In preparation for the national webinar, we created a resource guide that included templates and materials to facilitate and minimize barriers for state engagement. A weekly communication campaign with the webinar attendees was conducted over the month to engage and support attendees.

Results: The national webinar was held 43 days prior to October 4th with 39 attendees from 24 states. 10 states held events that acknowledged October 4th as TEN-4 Day, 6 states submitted a proclamation to the state governor, with 3 states obtaining gubernatorial proclamations.

Conclusion(s): Partnerships between state-level nonprofit community organizations, hospitals, national professional organizations, and state governments can scale a grassroots movement to establishing a national child abuse prevention day on October 4 as TEN-4 Day. This advocacy strategy allowed us to exceed our goal of number of participating states and achieve a more than 3-fold increase over the prior year.