Provider Perspectives on the Gaps in Knowledge, Skills, and Resources Necessary for Delivery of Trauma-Informed HIV Care: Implications for Future Curriculum Development Público
Varma-Lenz, Shanti (Spring 2021)
Published
Abstract
Background: Trauma-informed care has been an increasingly developed area of research over the past several decades. There is a significant need for trauma-informed care training that is specific to HIV care providers due to the high levels of trauma experienced by people living with HIV and the impact on their HIV outcomes. Few studies have assessed provider gaps in skills and knowledge in provision of trauma-informed care.
Methods: This thesis focuses on the qualitative study of a larger mix-methods study among providers and staff of Ryan White HIV Clinics in the Southeastern United States. Twelve in-depth interviews were conducted with HIV care providers, examining their perceptions of gaps in knowledge and skills to effectively provide trauma-informed care, factors influencing prioritization of implementation of trauma-informed care training, and preferences for content and delivery of training. Interviews were conducted and recorded via Zoom. All twelve interviews were then coded and analyzed, using thematic analysis.
Results: The study found that HIV care providers would like to see trauma-informed care curriculum implemented into medical education curricula and clinical training, in addition to re-training for practicing providers. Providers would also like to see trainings delivered by subject-matter experts. Providers are particularly interested in population specific trauma-informed care training, as well as trauma-informed care training that focusses on not re-triggering or re-traumatizing a patient.
Conclusions: The study provides critical insight into the content and delivery of trauma-informed care training for HIV care providers. Future research should pilot and evaluate implementation of such trauma-informed care training and examine effects on providing trauma-informed HIV care to people living with HIV. Furthermore, trauma-informed care trainings should be piloted and subsequently added to medical training.
Table of Contents
CHAPTER ONE: INTRODUCTION 1
CHAPTER TWO: LITERATURE REVIEW 3
Trauma: Definitions 3
Trauma Experience Among People Living with HIV 4
Trauma: Effects on Health 5
Trauma Among Providers and Staff 5
Trauma: Safeguards 6
Trauma-Informed Care: A Framework for Addressing Trauma Among Patients, Providers, and Staff 7
Trauma-Informed Care: The Evolving Role of the Clinic and Providers 10
Trauma-Informed Care: Present Make-Up/Delivery 11
Trauma-Informed Care: Integration into HIV Clinics 13
Ryan White HIV Primary Clinics: Ideal Settings for Implementation of Trauma-Informed Care 15
Trauma-Informed Care: Need for Trauma-Informed Care training of HIV Care Providers 16
A Need to Understand Gaps in Provider Knowledge and Skills to Inform Training of Providers 17
CHAPTER THREE: MANUSCRIPT 20
Abstract 20
Background: 20
Introduction 21
Methods 22
Study Overview: 22
Study Setting: 23
Participants: 24
Table 1 25
Data Collection: 26
Ethics: 27
Data Management: 27
Data Analysis 28
Results 28
Participant Characteristics 28
Existing Knowledge of Trauma-Informed Care & Trauma-Informed Care Trainings 29
Perceived Priority of Trauma-Informed Care Training 32
Factors Influencing Implementation of Trauma-Informed Care Training 34
Preferences of Trauma-Informed Care Training 36
Discussion 39
CHAPTER FOUR: CONCLUSIONS AND RECOMMENDATIONS 42
REFERENCES 44
APPENDICES 48
In-depth Interview Guide 48
CFIR Codebook 56
SAMHSA Codebook 69
About this Master's Thesis
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