TLC Family Resource Center is participating in a multipronged response to the opioid epidemic with Dartmouth-Hitchcock (D-H) by directly connecting with parents in recovery. This delivers consistent, personalized, and targeted support to families as they navigate the challenges of parenting—while also walking the path of substance abuse recovery.
 
TLC is currently participating with D-H Pediatrics in Lebanon and Valley Regional Pediatrics in Claremont through the Recovery-Friendly Pediatrics program, which is generously funded by the Couch Family Foundation. Staff members from TLC and The Family Place in Norwich spend time each week at the pediatric offices to introduce families to their programs. Their presence at the practices helps to eliminate barriers to program access for parents in recovery and serves to support children and families with needed resources.
 
Surveys conducted by D-H prior to the program development showed providers were spending approximately 50 percent of their patient time on social determinants of health resources—yet families reported feeling they weren’t receiving enough support in this area.
 
Holly Gaspar, Community Health Partnership coordinator for D-H’s Community Health Improvement, along with her team worked closely with Steven H. Chapman, MD, a pediatrician at the Children’s Hospital at Dartmouth-Hitchcock (CHaD) and the medical director for the Boyle Community Pediatrics Program, to design and launch Recovery-Friendly Pediatrics in response to the needs identified.
 
The ultimate goal of the program is to support families in recovery across support organizations, in order to protect vulnerable children and prevent adverse childhood experiences. These toxic stress experiences are proven to have long-term health implications—including heart disease, diabetes and often future substance abuse—for people with two to four adverse childhood experiences.
 
Sometimes parents in recovery are wary of trusting new people and programs, are embarrassed to reach out and/or believe they won’t qualify for services, according to Gaspar.
 
“The benefit of Recovery-Friendly Pediatrics is placing family resource program staff in the pediatrician’s office—a trusted environment—to educate, build rapport and enroll families after an introduction from their pediatrician or nurse,” she said.
 
From the introduction, the family resource center staff can share their programs, like “Growing Great Kids.” The program has trained educators helping to strengthen bonds between parents and children to prevent abuse and neglect, according to Maggie Monroe-Cassel, executive director of TLC.
 
“It’s important for our educators to tell parents they’re doing a good job, or point out, ‘Look at how she loves you. Look how she’s looking into your eyes,’” said Monroe-Cassel. “Maybe mom won’t use drugs that day. Building trust between parents and educators leads to very strong relationships, and parents will listen to that person.”
 
Other community pediatric practices are interested in joining this effort to eliminate health care silos. The program is continuing to evolve and is fine-tuning the best days and times to staff resource tables, encourage families to talk and process intake information on-site. 
 
“This is one of the best opportunities I have seen to provide recovery and parenting skills so babies are off to a good start,” Chapman says. “It’s helping us design a better system of care. This is the most meaningful work I’ve been a part of.”
 
For more information about Recovery-Friendly Pediatrics, contact Holly Gaspar at holly.a.gaspar@hitchcock.org. For more information about TLC and the programs they offer, please visit tlcfamilyrc.org or call 603-542-1848.

Adverse Childhood Experiences (ACEs) are an increasing area of interest among researchers, practitioners, and policymakers. As this field of study grows, an equity lens can facilitate a greater understanding of the structural, historic, and systemic contexts that relate to limited ACEs data for American Indians and Alaska Natives (AI/ANs), as well as disparate exposures to ACEs among this population. Three factors are important to consider in support of more equitable outcomes: AI/AN population characteristics, historical trauma and resilience, and tribal sovereignty.
​
First, characteristics of the AI/AN population require concerted efforts by researchers to include this population in the rapidly developing ACEs field. The population’s size and diversity, age distribution, and percentage of children living in poverty underscore this consideration. In the United States, an estimated 5.6 million people (1.7 percent of the total population) self-identify as AI/AN alone or in combination with one or more other races, and there are currently 573 federally recognized tribes.

[Read more here.]