Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level
Abstract Background The prevalence of trauma among individuals with HIV has prompted efforts to integrate trauma-informed care (TIC) into HIV care and treatment to improve health outcomes. A TIC Implementation Model, developed by a US capacity-building organization focuses on organizational changes,...
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2025-01-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-025-12287-7 |
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| author | Lindsay Senter Sabrina R. Baumgartner Allyson Crinklaw Emily Rebella Beth Hurley Kelly McCauley Lindsay Bryant Brita Loeb Paige Cervantes Stephanie Bogdewic Sarah Horwitz Barbara Cicatelli |
| author_facet | Lindsay Senter Sabrina R. Baumgartner Allyson Crinklaw Emily Rebella Beth Hurley Kelly McCauley Lindsay Bryant Brita Loeb Paige Cervantes Stephanie Bogdewic Sarah Horwitz Barbara Cicatelli |
| author_sort | Lindsay Senter |
| collection | DOAJ |
| description | Abstract Background The prevalence of trauma among individuals with HIV has prompted efforts to integrate trauma-informed care (TIC) into HIV care and treatment to improve health outcomes. A TIC Implementation Model, developed by a US capacity-building organization focuses on organizational changes, aligning cultural and physical environments, emphasizing values like safety and trustworthiness, engaging leadership, and training staff in skills-based TIC services. Despite growing research, gaps remain in understanding the relationship between organizational capacity, provider knowledge, and the dosage of technical assistance (TA) required to sustain TIC integration. Researchers investigated how the project team adapted the type and amount of TA based on initial Cultural Assessment scores (measuring core TIC values) and its impact on Implementation Status scores. Methods This study focuses on eight of 20 HIV care agencies in New Jersey that had largely met their TIC implementation goals by Spring 2022. As part of the TIC Implementation Model to measure agency capacity and implementation progress over time, agency staff and clients completed a Cultural Assessment (n = 72) and Physical Assessment (n = 43); staff completed a Pre/Post Training Survey (n = 296); and implementation teams at 8 agencies completed an Implementation Status Assessment Tool. Additionally, TA Logs capturing the details of TA meetings with the eight agencies were recorded by project staff. Data from these tools were analyzed in aggregate by agency using descriptive and correlational analyses. Results Results demonstrated responsive TA correlated with agencies’ baseline capacity. Agencies with lower capacity received significantly more frequent and extended TA encounters, which were associated with higher implementation scores and improvements in cultural environments for staff and clients (e.g., new protocols for staff response plans). Conclusions These findings underscore the importance of tailored TA in fostering diverse organizational cultures conducive to TIC implementation. For HIV care agencies, successful TIC implementation can impact health behaviors and outcomes for clients impacted by trauma. The TIC Implementation Model significantly advanced organizations’ ability to transform their culture and systems, increasing their capacity to implement and sustain TIC integration. These results align with existing research that emphasizes when time is invested to shift organizational culture and develop leadership, new practices can effectively be implemented and scaled-up. |
| format | Article |
| id | doaj-art-9c1126649b9c470d9fb9126f77cf3d74 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-9c1126649b9c470d9fb9126f77cf3d742025-02-02T12:14:27ZengBMCBMC Health Services Research1472-69632025-01-0125111610.1186/s12913-025-12287-7Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational levelLindsay Senter0Sabrina R. Baumgartner1Allyson Crinklaw2Emily Rebella3Beth Hurley4Kelly McCauley5Lindsay Bryant6Brita Loeb7Paige Cervantes8Stephanie Bogdewic9Sarah Horwitz10Barbara Cicatelli11Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Cicatelli Associates Inc. (CAI)Virginia Commonwealth University School of MedicineJames M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical CenterNYU Grossman School of MedicineCicatelli Associates Inc. (CAI)Abstract Background The prevalence of trauma among individuals with HIV has prompted efforts to integrate trauma-informed care (TIC) into HIV care and treatment to improve health outcomes. A TIC Implementation Model, developed by a US capacity-building organization focuses on organizational changes, aligning cultural and physical environments, emphasizing values like safety and trustworthiness, engaging leadership, and training staff in skills-based TIC services. Despite growing research, gaps remain in understanding the relationship between organizational capacity, provider knowledge, and the dosage of technical assistance (TA) required to sustain TIC integration. Researchers investigated how the project team adapted the type and amount of TA based on initial Cultural Assessment scores (measuring core TIC values) and its impact on Implementation Status scores. Methods This study focuses on eight of 20 HIV care agencies in New Jersey that had largely met their TIC implementation goals by Spring 2022. As part of the TIC Implementation Model to measure agency capacity and implementation progress over time, agency staff and clients completed a Cultural Assessment (n = 72) and Physical Assessment (n = 43); staff completed a Pre/Post Training Survey (n = 296); and implementation teams at 8 agencies completed an Implementation Status Assessment Tool. Additionally, TA Logs capturing the details of TA meetings with the eight agencies were recorded by project staff. Data from these tools were analyzed in aggregate by agency using descriptive and correlational analyses. Results Results demonstrated responsive TA correlated with agencies’ baseline capacity. Agencies with lower capacity received significantly more frequent and extended TA encounters, which were associated with higher implementation scores and improvements in cultural environments for staff and clients (e.g., new protocols for staff response plans). Conclusions These findings underscore the importance of tailored TA in fostering diverse organizational cultures conducive to TIC implementation. For HIV care agencies, successful TIC implementation can impact health behaviors and outcomes for clients impacted by trauma. The TIC Implementation Model significantly advanced organizations’ ability to transform their culture and systems, increasing their capacity to implement and sustain TIC integration. These results align with existing research that emphasizes when time is invested to shift organizational culture and develop leadership, new practices can effectively be implemented and scaled-up.https://doi.org/10.1186/s12913-025-12287-7Trauma informed careCapacity-assessmentsTechnical assistanceOrganizational-level practices |
| spellingShingle | Lindsay Senter Sabrina R. Baumgartner Allyson Crinklaw Emily Rebella Beth Hurley Kelly McCauley Lindsay Bryant Brita Loeb Paige Cervantes Stephanie Bogdewic Sarah Horwitz Barbara Cicatelli Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level BMC Health Services Research Trauma informed care Capacity-assessments Technical assistance Organizational-level practices |
| title | Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| title_full | Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| title_fullStr | Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| title_full_unstemmed | Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| title_short | Using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| title_sort | using capacity assessments and tailored technical assistance to advance trauma informed care integration at the organizational level |
| topic | Trauma informed care Capacity-assessments Technical assistance Organizational-level practices |
| url | https://doi.org/10.1186/s12913-025-12287-7 |
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