California's Youth-Led Live Beyond Campaign on Adverse Childhood Experiences Shows Early Impact, RAND Study Finds

What You Need to Know:

• Adverse Childhood Experiences (ACEs) are common, as nearly three out of five people have experienced at least one ACE—yet most people have never heard of them.
• In its first ten months, California's Live Beyond campaign reached an estimated 1.4 million youth and 1.6 million caregivers, raising awareness and encouraging positive coping strategies.
• Compared to pre-campaign levels, ACEs awareness increased by over 50 percent among California parents and caregivers, and more youth and caregivers regularly engage in self-care and stress-reduction activities–behaviors that reduce the impacts of ACEs and promote long-term health.

SACRAMENTO, Calif., Nov. 3, 2025 /PRNewswire/ -- A new study from RAND—a nonprofit, nonpartisan research organization— finds that California's statewide Live Beyond campaign — a first-of-its-kind, youth co-created effort to raise awareness of and promote living beyond Adverse Childhood Experiences (ACEs) and toxic stress — reached more than one in four California youth ages 16-25, and more than one in four caregivers of youth ages 8-16 in its first ten months. The study shows evidence that this approach is shifting public awareness, attitudes, and behaviors around ACEs and healing from them.

Why this matters: ACEs are stressful or potentially traumatic events that happen to us before the age of 18. Examples include having a caregiver who struggled with mental health or substance use, witnessing domestic violence, or experiencing abuse or neglect. ACEs are a serious public health concern with an estimated societal cost of $14.1 trillion per year in the United States, including $183 billion in direct medical costs, and an estimated yearly economic burden of $88,000 for each affected adult. Yet many people have never heard of ACEs, or know how to address the impacts.

"These findings underscore the urgent need for greater awareness of Adverse Childhood Experiences (ACEs) and their profound impact on lifelong health," said Dr. Diana E. Ramos, California Surgeon General, whose office leads the Live Beyond campaign under California's Children and Youth Behavioral Health Initiative. "When people understand ACEs and how to respond, it creates opportunities to prevent harm, foster healing, and reduce the long-term effects of trauma—opening the door to healthier futures for today's children and generations to come."

Key findings from RAND's evaluation include:

• Awareness of ACEs increased by over 50 percent among caregivers, with a similar pattern among youth.
• The campaign reached audiences more likely to be affected by ACEs, including immigrant youth, youth in foster care, and parents and caregivers with lower incomes and less education.
• Roughly two in three people who saw the campaign said the campaign made them want to learn more about ACEs, take action to protect their children from the effects of ACEs, and take steps to reduce stress.
• Spanish-language campaign content was particularly engaging among audiences, highlighting the importance of multilingual outreach.

"In ten months of the campaign, we saw measurable increases in ACE awareness and use of self-care strategies among youth and caregivers who reported seeing the campaign," said Dr.Rebecca Collins, a senior behavioral scientist at RAND. "These early findings suggest that even in a short timeframe, a public awareness campaign can be an effective way to improve knowledge and actions related to ACE outcomes."

For youth like Angelina Hinojosa, a Native youth advisor with Live Beyond and member of the Pinoleville Pomo Nation, the impact is personal. "I come from a strong Native family with a lot of generational trauma, and for a long time, we didn't talk about mental health," she said. "Live Beyond showed me that healing is possible and it's okay to ask for support. I'm proud we adapted the campaign for Native communities because culture is such a big part of healing."

Civilian , a California-based social impact agency, led the campaign's strategy development and outreach. "We set out to build something with youth, not just for them," said Camellia Mortezazadeh, Director of Strategy and Insights at Civilian. "These findings show that when young people lead, it resonates."

RAND reports are available here:

• To view the RAND study summary, click here: https://www.rand.org/pubs/research_reports/RRA3039-1.html
• To view the full RAND report, click here: https://www.rand.org/pubs/research_briefs/RBA3039-1.html
• Press materials, photos and a PSA on the campaign by California Surgeon General Dr. Diana Ramos, can be found here: livebeyondCA.org/media

ABOUT LIVE BEYOND 
Live Beyond is California's statewide public awareness campaign co-created with youth to raise awareness of Adverse Childhood Experiences (ACEs), toxic stress, and healing strategies. The campaign is part of the California Children and Youth Behavioral Health Initiative and is overseen by the Office of the California Surgeon General.

ABOUT RAND
RAND is a nonprofit research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier, and more prosperous.

Media Contact:
Ben Roussel
Director of Communications and Public Relations, Civilian
[email protected] | 202.210.3112

SOURCE Office of the California Surgeon General