Childhood trauma is a key risk factor for future substance use disorder, overdose, and suicide. This is particularly problematic in rural areas where children experience higher rates of adverse childhood experiences (ACEs). ACEs are commonly defined as physical and emotional abuse and neglect, sexual abuse, parental separation or divorce, intimate partner violence, and having household members with serious mental illness, substance use disorder, or a history of incarceration.
Now, a three-year, U.S. Department of Agriculture (USDA) grant awarded to the University of Missouri will help virtually train various members of the workforce -; such as healthcare providers, mental health and behavioral health providers, social workers, and even childcare providers, and dentists -; who serve individuals and families affected by ACEs in five high-risk rural Missouri counties with the ultimate goal of reducing opioid overdoses and suicides.
The five Missouri counties involved are Dent, Washington, Crawford, St. Francois and Phelps, all of which ranked among the highest in Missouri for drug overdose mortality rates in 2021. Julie Kapp, an associate professor in the MU College of Health Sciences and primary investigator for the grant, developed the online training module.
The grant involves collaborators from MU Extension, Show-Me ECHO; Office of Health Outreach, Policy and Education (HOPE); Missouri Telehealth Network; Missouri Center for Health Policy; and MO HealthNet (Missouri's Medicaid program).
More than 60% of adults nationally are exposed to ACEs in childhood, and these exposures are linked with increased risk for substance abuse and suicide. If we can target upstream factors such as ACEs, we are hopeful that we can reduce the pipeline that leads to substance abuse occurring in the first place."
Julie Kapp, Associate Professor, MU College of Health Sciences
Kapp added that many health care providers and other members of the workforce are unaware of ACEs, which leaves a significant gap and the need for training opportunities.
"Our goal is to provide additional tools beyond just prescriptions," Kapp said. "Someone struggling with substance abuse may have the desire to stop, but if they have never dealt with their childhood trauma, it will be an uphill battle. One of our former ACEs trainees who works with incarcerated individuals said, 'Many of [these individuals] do not identify their life experiences as traumatic. They view their traumas as typical.'"
The training module, which can be taken asynchronously and completed in approximately three hours, covers such topics as: what ACEs are; the prevalence of ACEs in rural areas; strategies to support families, emphasizing positive childhood experiences, resources available and developing a trauma informed care model.
"This evidence-based training module has already been well-received by members of various organizations in the Missouri workforce, and they have reported the content is informative, helpful and relevant," Kapp said.
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