2023 HOPE Summit

Tufts Medical Center, Boston MA

Investigators

Abstract

Experiences, both positive and negative, affect adult health outcomes. The HOPE framework offers a novel approach to trauma-informed care (TIC), based on including consideration of positive childhood experiences (PCEs) in all phases of care. Our annual summit accelerates awareness of this new framework, and forms a key part of the HOPE National Resource Center’s strategy for dissemination. Although adverse childhood experiences (ACEs) are associated with poor adult mental and physical health, PCEs also affect long-term health. In a 2019 study, validated survey items concerning specific PCEs were added to the Wisconsin Behavioral Risk Factor Surveillance System (BRFSS) survey. There was an inverse dose-dependent association between the number of PCEs reported and likelihood of adult depression or poor mental health regardless of the number of ACEs an individual recounted, demonstrating that PCEs can prevent and mitigate the effects of ACEs. The HOPE framework is centered on four building blocks: relationships with adults and other children; safe, stable and equitable environments to live, learn and play; social/civic engagement; and opportunities for social/emotional development. Implementation of this framework in practice builds on the existing TIC skills by adding consideration of specific PCEs that promote optimal development and resilience. HOPE promotes a relationship-based approach which transforms interactions between providers and parents, focuses on a family’s assets and strengths, and upholds family agency and expertise, leading to an alignment of the agency’s goals and family’s priorities. Assessments and interventions based on HOPE resist a top-down labeling of families as broken, highlight the systemic nature of certain problems, and value shared power in decision-making, bringing anti-racist approaches into practice improvement. This framework provides a balanced approach to assessment, workflow, and interventions that may help prevent ACEs, break the link between ACEs and adult health, and improve health outcomes. The HOPE National Resource Center supports national adoption of the HOPE framework in clinical and community-based settings through training, technical assistance, translational research, and evaluation. Our annual summit strategies power the diffusion of innovation model. “Spreading HOPE,” our 2021 national summit, focused on increasing awareness and understanding of the HOPE framework, supporting a broader community of innovators. Our second summit, supported by an R13 award from NICHD, focused on Growing HOPE, and spotlighted the interplay between family and community resilience, featuring a keynote address on “Building Resilient Communities” by Dr. Wendy Ellis. We also moved to a novel week of HOPE format, and developed multiple tools to foster engagement among summit participants. The 2023 Summit, “Practicing HOPE,” will focus on early adopters of HOPE-informed care. The week-long event will bring out new information, highlight new implementation resources, and showcase innovative practices.