GCRF: Trauma and Adverse Childhood Experiences Springboard (TrACES)

GCRF: Trauma and Adverse Childhood Experiences Springboard (TrACES) is a programme of pump priming funding that will be competitively allocated to academics and groups of academics within the University of Exeter to develop sustainable relationships with specified LMIC countries as part of an evolving global research platform.
The primary aim of this platform is to harness existing expertise and knowledge among UK researchers on early life trauma (including adverse childhood experiences) and the mechanisms and pathways leading from such trauma to a spectrum of mental health, substance and violence-related outcomes, and expand this into collaborative research partnerships with LMIC researchers working in this field. Such collaboration across diverse global settings will allow for adaptation of existing methodologies and co-creation of new approaches and research understanding in this neglected but critically important field.
The life-course trajectories leading from early life trauma to mental illness, substance use problems, and violent behaviours, have devastating personal and societal outcomes; and these impacts have particular importance for LMIC contexts where the burden is heaviest. These health and behavioural outcomes carry a huge human and socio-economic cost and threaten to undermine these nations' ability to achieve sustainable development targets.
There is an imperative therefore to collaborate across global contexts and across scientific disciplines to broaden and enrich the evidence base in this field. This future evidence-base needs to answer questions including how early experiences of trauma may lead to harmful mental health outcomes; how some individuals are resilient and remain well despite early adversities; and how these developmental pathways may differ between varied social, economic and cultural contexts.
The TRACES programme of funding will be for the first stage of establishing this global research platform. TRACES aims to springboard the building of global relationships and networks across disciplinary boundaries with the goals of a) making these partnerships sustainable b) prioritising the strengthening of research capacity across collaborations c) generating necessary pilot data and d) and winning large-scale competitive research awards that will support long-term programmes of research in this field. Ultimately, this research will provide the evidence for developing interventions that are effective and relevant to context.
While TRACES has a particular emphasis on partnerships with South Africa, we are also partnering with other LMICS (Uganda, India, Jamaica, Guyana and Colombia. Within the bounds of this funding, our emphasis on South Africa is strategic as we have particularly strong existing relationships with researchers in that country and are thus confident of success and realising immediate impact within the 12-month period of the award.
Our funding programme comprises three different funding mechanisms or entry levels that can springboard relationships with LMIC research partners. These are:
- Strategic Fund: 3-9 month pilot projects of £20-30k that will be used to collate preliminary data or developing methodologies in relation to specific research questions where a relationship within an LMIC is already established.
- Network Development: This stream will fund a series of workshops and network events, £10-30k, with LMIC partners and collaborators.
- Link Funds: These funds are about scoping the potential for further collaboration within LMICs. The award will fund up to £10k for a single workshop/meeting or exchange with an LMIC partner where there is not already an established relationship; and, if successful, awardees will be encouraged to upgrade to application for a network development award if feasible.

TRACES is a collaborative programme of research between the University of Exeter (UoE) and partners in South Africa, Uganda, India, Jamaica, Guyana and Colombia focused on early life trauma (including adverse childhood experiences) and its trajectories to mental illness, substance abuse and violence-related outcomes. Early life trauma (ELT) is highly prevalent, especially within low- and middle-income countries (LMICs) and is strongly associated with a wide spectrum of mental illness (including psychosis, mood and anxiety disorders, addictions, suicide and personality disorders). The major part of the global burden of these disorders is located in LMICs, yet research on the mechanisms and pathways through which ELT interacts with other aetiologies and leads to later mental illness is limited outside of high-income contexts. Research to date suggests that early trauma acts through epigenetic processes, disregulates hypothalamo-pituitary-adrenal pathways and immunological processes and disrupts cognitive-affective development. There is an urgent need to investigate these and other mechanisms within diverse geographical, social and cultural contexts so as to move forward our understanding and provide a basis for developing and testing interventions aimed at mitigating the effects of ELT and preventing consequent mental, substance and violence-related outcomes.

Adopting a developmental life-course perspective and a translational approach including multidisciplinary methods (i.e. genomics and epigenomics, neuroimaging, psychopharmacology, clinical, social and spatial epidemiology, cognitive and experimental neuroscience and neuropsychology), this programme provides pump-priming funding to support collaborative workshops, network-building and pilot studies that will establish our international research platform and provide a springboard for large-scale, multidisciplinary and collaborative grant applications that will enable this ambitious programme of research.

TRACES is being developed to strengthen existing, and build new collaborative partnerships between UoE and academic institutions in LMICs that will be sustainable after the project has come to an end. The programme intends to develop the understanding of UoE and its partners around identifying the mechanisms leading from early life trauma to mental illness, substance abuse and violence outcomes in later life, particularly in LMICs. By developing this understanding and knowledge, researchers, healthcare professionals and policy makers will be better equipped to understand the challenges related to treating ELT and subsequent adverse mental health outcomes. It is expected that the pilot activity developed as part of TRACES will become the foundation on which later interventions are developed that lead to young people who experience early life trauma receiving appropriate treatment and care so that they are able to build resilience and lead healthy and normal lives.
The countries we will partner with through TRACES are amongst the countries with the highest reported rates of various forms of interpersonal violence, child abuse and neglect, injuries and HIV worldwide. For example, South Africa has one of the highest prevalence rates of HIV and people living with AIDS and has one of the highest rates of interpersonal (and especially sexual) violence worldwide, while Guyana has the highest suicide rate globally. There is significant stigma around mental health in these countries and relatively limited provision to manage mental illness.
TRACES will benefit both Researchers (particularly those at our partner LMIC organisations) and local healthcare delivery staff. The impact from TRACES will be internationally felt as the programme, through the pump priming funding, will lay the foundations for future larger research projects across four continents and multiple LMIC countries through the creation of sustainable networks of researchers, and in some cases through the creation of pilot data. The programme will create opportunities for early stage researchers to build up a personal network of collaborators from across the globe as well as across a number of different sectors (education, policy, healthcare, charity). Similarly, the networks created will form a platform for knowledge sharing between UoE and our partners and will create opportunities for early stage researchers from our LMIC partners to be seconded to/gain experience at the UoE.
Benefits will be felt by residents of LMIC countries as the programme will open the dialogue around mental health and specifically early life trauma, which, due to lack of resources and competing priorities, is currently at the bottom of the priority list. Activity from this programme will lay the ground work to shift the cultural stigma of early life trauma from the victims, and through developing relationships with local (and traditional) healthcare practitioners, the pump priming funding will strengthen the research readiness of local clinical sites. Partnering with local community groups will enable them to be actively involved in shaping local understanding of relationship between ELT and later mental health illnesses. By opening the dialogue around the trajectories from early life trauma to later mental health issues, local healthcare delivery staff will benefit from resources and in some cases, pilot interventions developed to understand these connections and subsequently the context within which to view mental illnesses.
TRACES will work with a wide variety of community groups and frontline workers and the networks and events planned as part of this project will bring these groups together to talk about and understand the different challenges faced. It is expected that through bringing these groups together they will benefit from understanding the wider context around the issues that people who have experienced early life trauma face and therefore how they should be managed.