Abstract
Objective: To assess the attitudes and knowledge of behavioral health technicians (BHTs)
towards opioid overdose management and to assess the effect of online training on opioid
overdose response on BHTs’ attitudes and knowledge, and the confidence to identify and
respond to opioid overdose situations.

Design/Methods: Pre-intervention Opioid Overdose Knowledge Scale (OOKS) and Opioid
Overdose Attitude Scale (OOAS) surveys were administered electronically to five BHTs in
2020. Data obtained were de-identified. Comparisons between responses to pre-and post-surveys questions were carried out using the standardized Wilcoxon signed-rank statistical test(z). This study was conducted in a residential treatment center (RTC) with the institutional review board's approval from Arizona State University. BHTs aged 18 years and above, working at this RTC were included in the study.

Interventions: An online training was provided on opioid overdose response (OOR) and
naloxone administration and on when to refer patients with opioid use disorder (OUD) for
medication-assisted treatment.

Results: Compared to the pre-intervention surveys, the BHTs showed significant improvements
in attitudes on the overall score on the OOAS (mean= 26.4 ± 13.1; 95% CI = 10.1 - 42.7; z =
2.02; p = 0.043) and significant improvement in knowledge on the OOKS (mean= 10.6 ± 6.5;
95% CI = 2.5 – 18.7; z =2.02, p = 0.043).

Conclusions and Relevance: Training BHTs working in an RTC on opioid overdose response is
effective in increasing attitudes and knowledge related to opioid overdose management. opioid
overdose reversal in RTCs.

Keywords: Naloxone, opioid overdose, overdose education, overdose response program

Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma often exhibit behaviors that make educating them challenging. Preschool teachers at a southwestern United States preschool receive no training related to childhood trauma and resilience. The purpose of this project was to educate preschool teachers on trauma and resilience to improve attitude related to educating children with trauma.

Following Arizona State University Internal Review Board approval, preschool teachers were recruited from a non-profit metropolitan preschool. Project included two pre-training questionnaires (Adult Resilience Measure-Revised [ARM-R] and Attitudes Related to Trauma Informed Care scale [ARTIC]), one two-hour training via Zoom on childhood trauma and resilience, and post-training ARTIC questionnaire at two and six weeks.

Seven teachers (n=7) participated in pre-training questionnaires, and three of these teachers (n=3) participated in both post-training questionnaires. All participating teachers were female and Caucasian. Average age of participants was 49.43 years (SD=8.40, range 36-60), and experience average was 17.17 years (SD=10.15, range 3-30). AMR-R average score was 72.29 (SD=8.28, range 61-83). Pre-training ARTIC score average was 3.87 (SD=0.16). Post-training ARTIC scores at two weeks and six weeks post-training were 3.65 (SD=0.22) and 3.86 (SD=0.25).

Clinical significance included improved teacher awareness of childhood trauma and improved ability to interact with children exposed to trauma. Teachers exhibited high resilience scores. Additional research needed related to further address educating preschool teachers related to trauma informed care, related to building resilience in children, and related to the impact of teacher resilience on trauma informed care.

Keywords: teacher training, adverse childhood experiences, ACEs, childhood trauma, resilience

Research has shown adverse childhood experiences (ACEs) have a lifelong negative impact on a person’s physical, mental, and social well-being. ACEs refer to experiences related to abuse, household challenges, or neglect that occur before the age of 18. Some of the effects of ACEs include anxiety, depression, increased stress, increase in high-risk behaviors, and early death. Mindfulness practices have been shown to be an effective tool in reducing some of these symptoms. In looking for ways to prevent or mitigate the effects of ACEs, it is important to provide tools and resources to the adults taking care of children including; parents, guardians, and teachers.

The purpose of this evidence based project (EBP) was to evaluate mindfulness and classroom environments after the implementation of a mindfulness intervention. The intervention consisted of a three day training followed by four weeks of mindfulness practice prior to beginning the school day. Ten preschool and Early Head Start teachers from seven classrooms at a school in inner city Phoenix participated in the project. Utilizing the Five Factors Mindfulness Questionnaire pre and post intervention, a paired sample t-test showed a significant increase in two factors of mindfulness. The CLASS tool was used to assess classroom environment pre and post intervention and showed significant improvement in five classes. These findings support ongoing mindfulness training and practice for preschool and Early Head Start teachers to improve classroom environments.

Childhood traumatic experiences are a prevalent public health issue. Children exposed to trauma
often exhibit behaviors that make educating them challenging. Preschool teachers at a
southwestern United States preschool receive no training related to childhood trauma and
resilience. The purpose of this project was to educate preschool teachers on trauma and
resilience to improve attitude related to educating children with trauma. Following Arizona State
University Internal Review Board approval, preschool teachers were recruited from a non-profit
metropolitan preschool. Project included two pre-training questionnaires (Adult Resilience
Measure-Revised [ARM-R] and Attitudes Related to Trauma Informed Care scale [ARTIC]),
one two-hour training via Zoom on childhood trauma and resilience, and post-training ARTIC
questionnaire at two and six weeks. Seven teachers (n=7) participated in pre-training
questionnaires, and three of these teachers (n=3) participated in both post-training
questionnaires. All participating teachers were female and Caucasian. Average age of
participants was 49.43 years (SD=8.40, range 36-60), and experience average was 17.17 years
(SD=10.15, range 3-30). AMR-R average score was 72.29 (SD=8.28, range 61-83). Pre-training
ARTIC score average was 3.87 (SD=0.16). Post-training ARTIC scores at two weeks and six
weeks post-training were 3.65 (SD=0.22) and 3.86 (SD=0.25). Clinical significance included
improved teacher awareness of childhood trauma and improved ability to interact with children
exposed to trauma. Teachers exhibited high resilience scores. Additional research needed
related to further address educating preschool teachers related to trauma informed care, related to
building resilience in children, and related to the impact of teacher resilience on trauma informed
care.

Purpose: To assess the burnout levels of mental health workers and to evaluate the effectiveness
of promoting self-care practices in improving their well-being and resiliency.
Background and Significance: Burnout is highly prevalent among mental health workers due to
the nature of their work and the population of patients they serve. Turnover has been a
significant problem within this specialty for decades. Before the COVID-19 pandemic, the
mental health workforce was projected to experience shortage by 2025. The pandemic will likely
worsen this. Evidence from literature supports the effectiveness of promoting self-care towards
the development of resiliency and well-being in addressing burnout among healthcare workers.
Methods: The Maslach Burnout Inventory – Human Services Survey (MBI-HSS) was used to
assess the burnout levels of mental health workers in a psychiatric hospital in Arizona pre- and
post-intervention. Educational modules were provided for each participant to review. They were
asked to perform at least one self-care activity and to utilize the tools in the Provider Resilience
application every week for four weeks.
Results: Pre-intervention surveys indicated moderate levels of emotional exhaustion (m=20.71)
and depersonalization (m=9.29) and high levels of personal accomplishment (m=28.71).
Improvements were seen on emotional exhaustion (m=18.86), depersonalization (m=6.43), and
personal accomplishment (m=33.86) were seen post-intervention.
Conclusion: Although the results were not statistically significant due to small sample size, the
improvements seen on two out of three components of burnout (emotional exhaustion and
depersonalization) indicated that awareness of burnout levels and self-care practices contribute to
improving the well-being of mental health workers.