March Monthly Newsletter
Prevention Across the Lifespan: Preconceptual, Pregnancy, and Infancy
In this Issue:

  • Introduction: Prevention Across the Lifespan: Preconceptual, Prenatal and Infancy
  • Additional Resources
  • What's Happening Around the Region?
  • Epi Corner: Prevention Across the Lifespan: Preconceptual, Prenatal and Infancy

In the National Academies of Sciences, Engineering, and Medicine 2019 report, inter-generational prevention is emphasized for positively affecting mental, emotional and behavioral health (MEB). Over the next several months, the South Southwest will focus its monthly newsletter on the different developmental areas of intervention. The resources will include research findings, training, and recommended evidence-based prevention strategies.
 
This month, the focus is on the preconception, prenatal and infancy periods. There are many strategies that have a positive effect on substance use disorders and mental, emotional, and behavioral disorders; however focusing on environmental factors that put the fetus and infant at risk can have a positive effect on MEB throughout an individual’s lifetime.
 
The National Academies’ report describes some of the risks associated with adverse development in the fetus and infant. They include in utero exposure to cigarette smoke, alcohol, illicit drugs, some prescription drugs, and toxins; poor nutrition; maternal immune activation; maternal psychopathology, and maternal exposure to stress. These risks to the infant can negatively affect development by disrupting the developing fetus's brain and has an impact on the oxygen and nutritional resources between the mother and fetus. These factors may also have effects on postnatal mother-infant interactions. 1
 
There are many strategies outlined in the report, but this table gives us a brief description of some of the strategies we can consider in our efforts to address prevention at this level. Before reviewing ask yourself, what other ways have you considered each stage of development in your prevention work?
Additional Resources
Parenting Matters: Supporting Parents of Children Ages 0-8

Decades of research have demonstrated that the parent-child dyad and the environment of the family-which includes all primary caregivers-are at the foundation of children's well- being and healthy development. From birth, children are learning...

Read more
www.nap.edu
Neonatal Abstinence Syndrome: Primary Prevention Strategies

Neonatal Abstinence Syndrome (NAS) is a growing problem in the United States. NAS occurs when newborn babies experience withdrawal after being exposed to drugs in the womb. Fortunately, NAS is preventable if an expectant mother receives proper care.

Read more
www.youtube.com
Resources on Opioid Use During Pregnancy | CDC

CDC March of Dimes Substance Abuse and Mental Health Services Administration (SAMHSA) NIH National Institute on Drug Abuse American College of Obstetricians and Gynecologists (ACOG) CDC NIH National Institute on Drug Abuse SAMHSA US Department of ...

Read more
www.cdc.gov
Infographic: Adverse Childhood Experiences
Looking at How ACEs Affect our Lives & Society
Centers for Disease Control and Prevention (CDC)
Between 1995 and 1997, over 17,000 people receiving physical exams completed confidential surveys containing information about their childhood experiences and current health status and behaviors. The information from these surveys was combined with results from their physical exams to form the study’s findings.

Free Online Training: Preventing Adverse Childhood Experiences
Centers for Disease Control and Prevention
This training will help you understand, recognize, and prevent ACEs. You’ll learn about risk and protective factors, outcomes associated with ACEs, and evidence-based strategies you can use to reduce or eliminate the impact of ACEs and stop them from occurring in the first place.

Centers for Disease Control, Division of Reproductive Health Twitter Account
Follow the CDC Division of Reproductive Health to learn about ways to improve women’s health, pregnancy health and giving infants the healthiest start in life.
 
Is it safe for mothers who use marijuana to breastfeed?
Centers for Disease Control and Prevention
Using marijuana while breastfeeding can allow harmful chemicals to pass from the mother to the infant through breast milk or secondhand smoke exposure. To limit potential risk to the infant, breastfeeding mothers should be advised not to use marijuana or products containing cannabidiol (CBD) in any form while breastfeeding. Further information on this topic is provided in the Learn More section at the bottom of this webpage.
 
Case Study: Learning from Oklahoma’s Adverse Childhood Experiences Story
National Center for Injury Prevention and Control, Division of Violence Prevention
There are many childhood and adolescent experiences that can have a tremendous impact on lifelong health and opportunity. For example, exposure to violence as a child has been linked to a host of poor outcomes. This case study briefly highlights how the state of Oklahoma supported ACE data collection and used their data to inform child maltreatment prevention efforts. It also provides examples of Oklahoma’s next steps in their child maltreatment prevention work.

Fetal Alcohol Spectrum Disorders (FASDs) Homepage
Centers for Disease Control and Prevention
This page provides multiple resources to include training, information and resources on diagnosis, prevalence, prevention and interventions for FASDs
What's Happening Around the Region?
Prevention Technology Transfer Center, Substance Abuse Prevention Skills Training (SAPST) Trainer Learning Community and Materials Portal

The PTTC Network is pleased to announce the launch of a new online learning community specifically for SAPST Trainers and Training Coordinators who arrange for the delivery of the SAPST four-day face-to-face training by engaging SAPST trainers and/or preparing material and logistics. Inside this virtual community, one will have access to the updated SAPST materials, upcoming SAPST and SAPST ToT events, and training tips from SAPST Master Trainers. Individuals will be able to connect with other SAPST Trainers from across the U.S. and share ideas and resources.

To register for the PTTC SAPST Trainer Learning Community and Materials Portal, visit www.tinyurl.com/SAPSTLearningCommunity .

For more information about how the PTTC Network supports the SAPST please visit: https://pttcnetwork.org/centers/global-pttc/network-sapst .
NEW Self-guided Learning Courses
 
Informing Prevention: Adolescent 6-part Webinar series
  • Informing Prevention: Understanding Adolescent Development (1 of 6)
  • Informing Prevention: Effectively Engaging Adolescents in Interventions (Part 2 of 6)
  • Informing Prevention: Effective Use of Epidemiological Data (Part 3 of 6)
  • Informing Prevention: Effectively7 Using Technology for School-Based Prevention (Part 4 of 6)
  • Informing Prevention: The Effects of Drug Use on Adolescent Brain Development (Part 5 of 6)
  • Informing Prevention: Vaping Among Adolescents (Part 6 of 6)

Today’s Marijuana: Stronger, More Edibles, Confusing Information about Driving

Early Childhood Development: Toxic Stress and Adverse Childhood Experiences
 
Online Courses
All online courses can be accessed at: healtheknowledge.org/courses
 
If you are new to HealtheKnowledge, please log in or set up an account here: healtheknowledge.org/new-user
The South Southwest PTTC is currently suspending in-person training and meetings until further notice. Virtual services will proceed as scheduled.
2020 PFS Academy: Making the Steps of the Strategic Prevention Framework Work for You.

Each webinar will begin at 8:00 PT/9:00 MT/10:00 CT/11:00 ET

SAMHSA’s Strategic Prevention Framework (SPF) provides practitioners with comprehensive guidance to more effectively address substance misuse and related behavioral health problems in their communities. This seven-part webinar series will explore this five-step, data-driven process to identify genuine prevention needs, build capacity and plans to address those needs, implement effective programs and interventions, and evaluate and continually improve prevention efforts.

At each step of the SPF, and in separate sessions, practitioners will learn to incorporate the guiding principles of cultural competence and sustainability to help support the implementation of SAMHSA’s Strategic Prevention Framework (SPF). 

Certificates for prevention hours will be available upon registration and completion of the webinar.
 
  • March 24, Part 2: Capacity Building, will guide participants through the process of improving community readiness and increasing the resources available to support prevention efforts.
 
  • April 21, Part 3: Planning, will prepare participants to plan to address prevention problems identified during the needs assessment step.
 
  • May 19, Part 4: Implementation, will provide participants with the tools needed to implement prevention programs, policies, and practices with fidelity and effectiveness.
 
  • June 23, Part 5: Evaluation, will offer helpful guides for the collection and analysis of prevention strategies and teach participants how to modify programming for future enhanced results.

  • July 21, Part 6: Sustainability,will provide participants with the elements needed for a sustainable prevention program and how to integrate sustainability into each step of the SPF.
 
Epi Corner

Iris Smith, Ph.D., M.P.H.
South Southwest Prevention Technology Transfer Center
Prevention Across the Lifespan: Preconceptual, Prenatal and Infancy

 
The Consensus Study Report by the National Academies of Sciences, Engineering and Medicine, Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth (2019), 1 urges us as prevention practitioners, researchers and policymakers to broaden the lens through which we view prevention. Research has shown that there is a dynamic interaction among genetic, biological, social, and environmental influences from preconception to adulthood. This expanded view of the influences on health and behavior has important implications for prevention.
 
Preconception
There is a growing body of research that suggests early exposure to life stress or adverse childhood experiences are major risk factors for developing physical, psychiatric, and behavioral disorders in adulthood. Even preconception maternal stress may alter the uterine environment and influence the way the child responds to future environmental challenges. 2  Studies of both animals and humans have indicated that the effects of parental preconception exposures can influence neurodevelopmental and behavioral traits across generations. For example, women with a history of mental health problems prior to pregnancy are more likely to experience perinatal and postnatal depression. Other studies have found an association between self-harm during young adulthood and difficulties with mother-infant bonding. 1 Findings from this body of research highlight the importance of identification and early intervention for young women experiencing depression or life stress prior to or during pregnancy. Women with a history of adverse childhood experiences (ACEs), domestic violence, poverty, and women who have been in the military and were exposed to combat situations may be at higher risk. 3
 
Prenatal Influences
The impact of prenatal exposures to poor nutrition, environmental toxins prescription medications, alcohol, opioids, tobacco, and other illicit drugs are well established as potential threats to healthy physical and mental development. Fetal Alcohol Spectrum Disorder (FASD) and Neonatal Abstinence Syndrome (NAS) are known consequences for prenatal alcohol and opioid use by the mother during pregnancy. Illicit drugs such as marijuana, methamphetamine, and cocaine are known to cause preterm birth, perinatal complications, postnatal growth deficiency, and other neurodevelopmental problems. Prenatal prevention strategies include routine screening and access to appropriate behavioral health interventions for women during pregnancy. Infants who are at risk for Neonatal Abstinence Syndrome (NAS), Fetal Alcohol Spectrum Disorder (FASD), or other congenital abnormalities should be screened and treated.
 
Infancy and Early Childhood
The first three years of life are considered to be a critical period in human development. Exposure to child neglect or abuse, disruptions in mother-child interactions as a result of depression, drug use, poor nutrition and other forms of environmental deprivation can have a profound effect on development. Research on the children of mothers experiencing postpartum depression found that they are at increased risk for behavioral difficulties such as irritability, sleep problems, and excessive crying. These behaviors can create challenges for healthy mothers but can be especially challenging for women struggling with addiction or other behavioral disorders themselves. A study by Sirvinskiene, Zemaitiene, Zaborskis et al.(2012) found that maternal age, poor prenatal and postnatal emotional well-being, prenatal alcohol consumption, relationship issues, and negative reactions to the pregnancy increased the likelihood that many of the difficult infant behaviors would continue through the first year of the infant’s life. 4 This study also highlighted the importance of the paternal role during the first year of life. 
 
The National Academies of Sciences Consensus Report (2019) 1 strongly recommends considering prevention from a generational perspective. Such generational strategies include:
 
  • Parenting programs for young families to enhance skills and knowledge of healthy child development.
  • Programs to address parental issues such as depression, anxiety, PTSD, substance abuse, other behavioral disorders and exposure to community or domestic violence.
  • Screening of mothers and infants, postnatal follow up and early intervention programs for young children at risk for developmental problems such as those prenatally exposed to alcohol or other drugs or living with a person with a substance use disorder, mental health disorder, or otherwise dysfunctional parents. One group often overlooked are youth who enter the juvenile justice system. Many of these youth have experienced ACEs, but more importantly many are, or will, become young parents.
  • Home visitation programs for families at risk for child abuse/neglect.
 
The generational perspective provides us with multiple points and levels of intervention to promote the well-being of individuals, families and the community at large. Effective interventions that address risk and protective factors before conception, during pregnancy or early childhood have the potential to influence developmental outcomes in future generations.
 
 
Resources
 
 
National Intimate Partner and Sexual Violence Survey ( NISVS )
 
 
Youth Risk Behavior Surveillance Survey ( YRBSS ) .
 
Potential sources of data for tracking risk for ACEs:

  • Office of Juvenile Justice and Delinquency Prevention, National Survey of Children’s Exposure to Violence (NatSCEV),
  • National Survey of Children’s Health (NSCH)
  • Kids Count : online database that profiles well-being in each state
  • Child’s Trend Database: National and subgroup indicators of child and youth well-being
 

1National Academies of Sciences, Engineering and Medicine (2019). Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda. Washington, DC. The National Academies Pres, doi: https://doi.org/10.1722625201

2Provencal N & Binder EB (2015). The Effects of Early Life Stress on the Epigenome: From Womb to Adulthood and Even Before; Experimental Neurology, 268, pg. 10-20.

3McCabe JE, Katon JG, Ma E, Fortney JC, Grote NK, Zephyrin LC & Callegari LS (2018). Preconception Health Risk Factors in Women with and Without a History of Military Service. Womens Health Issues 28(6), pg. 539-545.

4Sirvinskiene G, Zemaitiene N, Zaborskis A, & Jusiene R (2012). Infant Difficult Behaviors in the Context of Perinatal Biomedical Conditions and Early Child Environment . BMC Pediatr, 12(44), pg. 12-44.