Weber Stephanie, Hardesty Canyon, Witwer Andrea, Dahl Ethan, Bush Elsie, Thomas Jessy, Baker Tai, Dudley Ally, Moody Eric J
Division of Developmental and Behavioral Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Front Public Health. 2024 Nov 18;12:1478039. doi: 10.3389/fpubh.2024.1478039. eCollection 2024.
Neonatal abstinence syndrome (NAS) is a complex condition resulting from prenatal substance exposure that has become increasingly prevalent as a result of the opioid epidemic. NAS can lead to long-term developmental challenges. Interdisciplinary teams with experience working with children with disabilities that focus on social determinants of health can be effective at supporting families affected by NAS. Unfortunately, interdisciplinary teams often lack sufficient training, ongoing practice support, and public health policies to support these families. The objective of this project was to determine the feasibility and impact of a National Training Initiative, called Project SCOPE, to improve the capacity of providers to address the needs of children with NAS and their families.
Fourteen (14) sites were trained to fidelity in the ECHO model and SCOPE curriculum, and then each team implemented this model for at least one, eight to 12 session series between 2019-2022. The reach, impact, satisfaction, and intention to implement the model were assessed from administrative records, pre/post surveys, and post-session evaluations.
SCOPE state teams delivered the curriculum to 9,392 individuals across 33 US states. Surveys from 2,197 individuals were used for analysis. Most participants (84%) had previous training in trauma informed care, but only 53% had any training on the NAS or the opioid crisis' impact on children. Satisfaction with SCOPE sessions was high (96.4%), and there was a statistically significant increase of self-reported knowledge change from pre- to post-SCOPE. Over 94% reported their skills increased because of participation. Over 97% of participants indicated their motivation to work with this population increased from SCOPE participation and that they could successfully apply what they learned. Almost 70% reported they were "very" or "extremely" likely to use their new skills.
Project SCOPE is a highly effective and impactful model that can radically improve capacity to support children affected by the opioid epidemic, thereby increasing the capacity of our healthcare system to respond to this epidemic. Moreover, this model can be rapidly deployed and reach a wide geographic region, especially areas that are affected by the opioid crisis and underserved rural communities.
新生儿戒断综合征（NAS）是一种因产前接触药物而导致的复杂病症，由于阿片类药物流行，其发病率日益上升。NAS会导致长期的发育挑战。由具有与残疾儿童工作经验且专注于健康社会决定因素的跨学科团队，能够有效地支持受NAS影响的家庭。不幸的是，跨学科团队往往缺乏足够的培训、持续的实践支持以及公共卫生政策来支持这些家庭。本项目的目标是确定一项名为“项目SCOPE”的全国培训计划的可行性和影响，以提高医疗服务提供者满足NAS患儿及其家庭需求的能力。
14个地点接受了ECHO模式和SCOPE课程的精准培训，然后每个团队在2019年至2022年期间至少实施了一个为期八至十二个课时的系列培训。通过行政记录、课前/课后调查以及课后评估来评估该模式的覆盖范围、影响、满意度和实施意愿。
SCOPE州级团队向美国33个州的9392人提供了该课程。对2197人的调查用于分析。大多数参与者（84%）此前接受过创伤知情护理培训，但只有53%接受过任何关于NAS或阿片类药物危机对儿童影响的培训。对SCOPE课程的满意度很高（96.4%），并且从课前到课后，自我报告的知识变化有统计学上的显著增加。超过94%的人报告称，由于参与培训，他们的技能有所提高。超过97%的参与者表示，参与SCOPE培训后，他们与这一群体合作的积极性有所提高，并且能够成功应用所学知识。近70%的人报告称，他们“非常”或“极其”有可能运用所学新技能。
项目SCOPE是一个高效且有影响力的模式，能够从根本上提高支持受阿片类药物流行影响儿童的能力，从而增强我们医疗系统应对这一流行情况的能力。此外，该模式可以迅速部署并覆盖广泛的地理区域，特别是受阿片类药物危机影响且服务不足的农村社区。
