Project Grant 20234610041099

** AWARDS ISSUED PRIOR TO JANUARY 20, 2025, WERE FUNDED UNDER PREVIOUS ADMINISTRATIONS AND MAY NOT REFLECT THE PRIORITIES AND POLICIES OF THE CURRENT ADMINISTRATION.** THE FLOODING OF THE MARKET WITH OPIOIDS AND RISING VULNERABILITY OF THE U.S. POPULATION ON EMOTIONAL AND PHYSICAL PAIN INDICATORS CREATED THE PERFECT STORM FOR DEATHS OF DESPAIR. THE INTERSECTION OF ADVERSE CHILDHOOD EXPERIENCES (ACES), SUICIDE, AND OVERDOSE IS A PRIORITY AREA FOR U.S. FEDERAL AGENCIES, INCLUDING THE U.S. DEPARTMENT OF AGRICULTURE. MISSOURIANS FACE HIGHER FREQUENCIES OF MENTAL AND PHYSICAL DISTRESS, DEPRESSION, AND PREMATURE DEATH THAN PEOPLE IN AT LEAST 40 OTHER STATES. IN 2019-2020, MISSOURI RANKED 17TH NATIONWIDE ON ACES. RURAL CHILDREN ARE MORE LIKELY THAN URBAN CHILDREN TO EXPERIENCE ACES. WE PROPOSE TO ADDRESS THE UPSTREAM FACTORS OF ACES ON THE DEATHS OF DESPAIR CRISIS IN MISSOURI BY TARGETING FIVE HIGH NEEDS RURAL COUNTIES THROUGH OUR ADVERSITY TO ACTION PROGRAM. IN 2021, THESE COUNTIES RANKED WORST IN THE STATE ON DRUG OVERDOSE MORTALITY, BEHIND ONLY ST. LOUIS CITY. ADVERSITY TO ACTION WILL IMPLEMENT EVIDENCE-BASED AND FIELD-TESTED DISTANCE LEARNING STRATEGIES THROUGH A MULTI-LEVEL ECOLOGICAL APPROACH TO SUPPORT INDIVIDUALS AND FAMILIES AND MITIGATE ACES AND THEIR IMPACTS THROUGH OUR ROBUST NETWORK OF PARTNERS ACROSS PRIMARY, SECONDARY, AND TERTIARY PREVENTION LEVELS. GUIDED BY THE NATIONAL ACADEMY'S THEORETICAL FRAMEWORK OF A LIFE-COURSE MULTILEVEL MODEL OF FACTORS INVOLVED IN THE HIGH AND RISING MORTALITY RATES, WE WILL ACHIEVE OUR PROJECT GOALS THROUGH FOUR OBJECTIVES: 1) DELIVER DISTANCE LEARNING PROGRAMMING TO INTERPROFESSIONAL PROVIDERS; 2) EMPOWER SUCCESS THROUGH CULTURAL-SENSITIVITY; 3) ENGAGE PARTNERS THROUGH OUR ROBUST MU EXTENSION AND RURAL NETWORKS; AND 4) LEVERAGE THE RECENTLY EXPANDED MISSOURI MEDICAID CLAIMS DATA TO EVALUATE EFFECTIVENESS.