ADDRESSING TRAUMA IN URBAN YOUTH: EVALUATING THE IMPLEMENTATION OF BALTIMORE CITY HEALTH DEPARTMENT’S CITYWIDE TRAUMA-INFORMED CARE TRAINING INTERVENTION

trauma;trauma-informed care;adverse childhood experiences;implementation science;mixed methods;Public Health Studies

Damian, April Joy GBowie, Janice ;

Johns Hopkins University

关键词: trauma;    trauma-informed care;    adverse childhood experiences;    implementation science;    mixed methods;    Public Health Studies;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60239/DAMIAN-DISSERTATION-2017.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Adverse childhood experiences are associated with negative short- and long-term biological, psychological, and social consequences for youth, thereby posing a significant public health problem. While there is substantial evidence supporting treatments to address trauma and prevent the negative sequelae of trauma, far less attention has been devoted towards the pathway by which traumatized youth are able to access the needed treatments and services. Furthermore, there is a dearth of research considering how adult professionals outside of the traditional healthcare system who have contact with traumatized youth can serve as potential gatekeepers and support youth in accessing trauma-specific treatments and services. An examination of trauma-informed care (TIC) interventions that engage non-clinicians in becoming more aware of how to recognize trauma in youth and respond appropriately to youth that have experienced trauma may be a viable strategy for promoting the healing of traumatized youth. This study combines quantitative and in-depth, qualitative data to advance understanding of a TIC training intervention’s impact on improving organizational and provider capacity to recognize and respond appropriately to youth that have experienced trauma, and the contextual factors that may influence the proposed impact. In response to the Baltimore unrest in April 2015 and the heightened awareness of the high prevalence of trauma among Baltimore City youth, the Baltimore City Health Department (BCHD) in partnership with Behavioral Health System Baltimore, developed the Healing Baltimore initiative through a grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services, National Center for Trauma Informed Care. Part of the vision of the Healing Baltimore initiative was to have all frontline workers trained in TIC. The first two aims of this study draw upon data from pre-post surveys with providers in the training that were conducted at the beginning and the conclusion of the BCHD’s nine-month TIC training intervention. All three aims use qualitative data collected during the semi-structured interviews conducted shortly after the conclusion of the intervention. In Aim 1, we examined changes in trainees’ knowledge about trauma, attitudes towards individuals that have experienced trauma, and beliefs about capacity to respond appropriately to traumatized individuals. Aim 2 evaluated changes in organizational and provider level factors associated with TIC implementation. Aim 3 involved the use of qualitative methods to explore the barriers and facilitators to providing trauma treatment or making referrals to trauma-specific treatments and services from the perspectives of providers.