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关注阿片类药物危机对幼儿发展影响的早期干预和儿童保育人员异步培训的效果。

Impact of an Asynchronous Training for the Early Intervention and Childcare Workforce Addressing the Developmental Impact of the Opioid Crisis on Young Children.

机构信息

Nisonger Center LEND Program, Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Department of Psychiatry, Creighton University, 7101 Newport Avenue, Suite 203, Omaha, NE, 68152, USA.

出版信息

Matern Child Health J. 2023 Aug;27(8):1361-1369. doi: 10.1007/s10995-023-03679-4. Epub 2023 Jun 1.

Abstract

OBJECTIVES

The US opioid epidemic contributes to a growing population of children experiencing neonatal abstinence syndrome (NAS) and adverse childhood experiences (ACEs). A review of the developmental impacts of the opioid crisis highlights that both prenatal exposure to teratogens and ACEs can result in developmental delay and disabilities. Training for the early intervention/early childhood (EI) systems is needed to enable them to meet the needs of this growing population.

METHODS

To address this, an IRB-approved online training on best practices for NAS, developmental monitoring and referral, and trauma-informed care was created for Ohio EI providers who provided informed consent to participate. The feasibility of utilizing an online training was assessed. Knowledge on opioid addiction, NAS, ACEs, and early intervention provider characteristics were collected for 2973 participants.

RESULTS

Within 6 months, the training reached providers in all Ohio counties and seventeen other states. 57% of providers reported caring for one or more children with a caregiver who has confirmed opioid use. 31% reported these children had experienced four or more ACEs. Providers' ACEs awareness was moderately associated with their experiences with prenatally-exposed youth. There was a significant increase in knowledge following training. Differences in post-training knowledge differed only by county-level opioid death rates, where those providers with low-medium opioid death rates reported more awareness of children with prenatal opioid exposure compared to participants who lived in a county with medium and medium-high opioid death rates.

CONCLUSIONS

Online-training is feasible for closing gaps in the early intervention system.

摘要

目的

美国阿片类药物泛滥导致经历新生儿戒断综合征(NAS)和不良童年经历(ACEs)的儿童人数不断增加。对阿片类药物危机对发育影响的综述表明,产前暴露于致畸物和 ACEs 都会导致发育迟缓及残疾。需要对早期干预/幼儿(EI)系统进行培训,使他们能够满足这一不断增长的人群的需求。

方法

为了解决这一问题,为俄亥俄州 EI 提供者创建了一项经过机构审查委员会批准的关于 NAS、发育监测和转介以及创伤知情护理最佳实践的在线培训,这些提供者同意参与并提供了知情同意。评估了利用在线培训的可行性。共收集了 2973 名参与者的阿片类药物成瘾、NAS、ACEs 和早期干预提供者特征方面的知识。

结果

在 6 个月内,培训覆盖了俄亥俄州所有县和其他 17 个州的提供者。57%的提供者报告照顾过一个或多个有经证实阿片类药物使用的照顾者的儿童。31%的提供者报告这些儿童经历了四个或更多 ACEs。提供者对 ACEs 的认识与其接触过的产前暴露于阿片类药物的青少年经历中度相关。培训后知识显著增加。仅县一级阿片类药物死亡率的差异导致了培训后知识的差异,与生活在中低阿片类药物死亡率县的参与者相比,低中阿片类药物死亡率县的参与者对有产前阿片类药物暴露的儿童的认识更为强烈。

结论

在线培训对于缩小早期干预系统的差距是可行的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bbf/10234582/187a7f926945/10995_2023_3679_Fig1_HTML.jpg

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