Trauma-Informed Care Training in Ryan White HIV Clinics: Is the Content Relevant to Clinics in the Southeastern US? Restricted; Files Only

Abstract

Background

People living with HIV are disproportionately burdened by trauma and its negative association on health outcomes. Thus, it is important to integrate trauma-informed care (TIC) into HIV spaces. Ryan White HIV clinics offer services to people with HIV across the country. A TIC training series was developed to strengthen the capacity of Ryan White HIV clinics to provide TIC to their patients. However, there is a need to assess content relevance, training feasibility, and staff attitudes of the TIC training across Ryan White Clinics (RWCs) in the Southeastern US in order to be widely disseminated.

Methods

From July 2024 to August 2024, 88 semi-structured surveys were collected from RWC staff across eight Southeastern US states. The data was analyzed using descriptive statistics and qualitative responses were thematically analyzed.

Results

This study revealed that all survey participants found this TIC training valuable. Most participants considered the six-session TIC training and Change Team development acceptable and feasible. Respondents emphasized that a flexible training schedule and a virtual option could enhance feasibility. Most participants also indicated that a Change Team, to facilitate clinic-tailored changes brainstormed in the training, would be valuable at their clinic.

Discussion

This study illustrates that the TIC training is likely valuable and feasible for RWCs across the Southeastern US. It provides valuable insight on content relevance, training feasibility, and staff attitudes of a TIC training, coupled with coaching and a Change Team. Future research should pilot this TIC training at a RWC clinic and evaluate the impact on staff, patients, and the care delivered. If successful, the TIC training can be disseminated to other RWCs across the nation and integrated into routine clinical practice.  

Table of Contents

CHAPTER 1: INTRODUCTION 1                                                                                 

CHAPTER 2: LITERATURE REVIEW 3

 Defining Trauma 3

Trauma in People Living with HIV (PLH) 3

 Effects of Trauma on Mental Health 5

 Trauma-Informed Care (TIC) 6

 Trauma-Informed Care (TIC) in People Living with HIV 8

 Trauma-Informed Interventions in HIV Settings and their Effects 9

 Trauma-Informed Care Trainings in HIV Settings and their Effects 11

 Differences across Ryan White HIV Clinics in the Southeastern US 13

 Trauma-Informed Care Ryan White Training Series 4

 Study Aims 16

 CHAPTER 3: MANUSCRIPT 17

 Abstract 17

 Introduction 18

 Methods 20

 Results 24

 Discussion 36

 CHAPTER 4: PUBLIC HEALTH IMPLICATIONS 41

 Implications for Future Research 41

 Implications for Future Practice 42

 Implications for Future Policy 43

 REFERENCES 44

 APPENDIXES 52

 APPENDIX A: Survey Tool 52

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Trauma-Informed Care training HIV Trauma-Informed Care
Committee Chair / Thesis Advisor	Kalokhe, Ameeta, Emory University

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