Process Mapping to inform implementation of Trauma-Informed Care for youth aged 14-24 with HIV in the Southern United States.

Autor:	Brown LL; Meharry Medical College School of Medicine., Wilkins ML; St Jude Children's Research Hospital., Pichon LC; The University of Memphis., Stewart JL; Meharry Medical College School of Medicine., Sales JM; Emory University School of Public Health., Audet CM; Vanderbilt University Medical Center., Hill SV; The University of Alabama at Birmingham Department of Medicine., Pettit AC; Vanderbilt University School of Medicine.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2023 Aug 14. Date of Electronic Publication: 2023 Aug 14.
DOI:	10.21203/rs.3.rs-3234952/v1
Abstrakt:	Background: Trauma-Informed Care (TIC) is an evidence-based approach for improving health outcomes by providing systematic, trauma- sensitive and -responsive care. Because TIC adoption varies by setting and population, Implementation Science (IS) is particularly well-suited to guide roll-out efforts. Process Mapping (PM) is an IS model for creating shared visual depictions of systems as they are to identify rate-limiting steps of intervention adoption, but guidance on how to apply PM to guide TIC adoption is lacking. Authors of this study aimed to develop a novel method for conducting TIC-focused PM. Methods: A real-life TIC implementation study is presented to show how TIC-focused PM was conducted in the case example of a pediatric HIV clinic in a Southern urban area with a high burden of psychological trauma among youth with HIV. A five-phase PM model was applied to evince clinic standards of care, including Preparation, planning and process identification; Data and information gathering; Map generation; Analysis; and Taking it forward. Practices and conditions from four TIC domains were assessed, including Trauma responsive services; Practices of inclusivity, safety, and wellness; Training and sustaining trauma responsiveness; and Cultural responsiveness. Results: The TIC-focused PM method indicated the case clinic provided limited and non-systematic patient trauma screening, assessment, and interventions; limited efforts to promote professional quality of life and elicit and integrate patient experiences and preferences for care; no ongoing efforts to train and prepare workforce for trauma- sensitive or -responsive care; and no clinic-specific efforts to promote diversity, equity, and inclusion for patients and personnel. Conclusion: Principles and constructs of resilience-focused TIC were synthesized with a five-phase PM model to generate a baseline depiction of TIC in a pediatric HIV clinic. Results will inform the implementation of TIC in the clinic. Future champions may follow the TIC-focused PM model to guide context-tailored TIC adoption. Competing Interests: Competing interests There are no competing interests.
Databáze:	MEDLINE
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