Evaluation of a trauma-informed care (TIC) training program across community health centers in Texas: a qualitative study.

Background: In April 2019, Texas Association of Community Health Centers launched the Trauma-Informed Care (TIC) program in community health centers across Texas. This initiative aimed to transform organizational culture for consistent delivery of TIC by providing training and coaching opportunities for Trainers and Champions in each health center. This study is an interim qualitative evaluation to gain participants' insights into their experiences of and perceptions about TIC training as part of the TIC initiative.

Methods: We conducted semi-structured key informant interviews via Zoom with Trainers across four cohorts of participating health centers between February 2020 and April 2023. We used rapid assessment procedures to conduct analysis in tandem with data collection given the ongoing TIC training. We present salient quotes to illustrate the emergent themes.

Results: We interviewed a total of 36 Trainers and identified the following emergent themes from the interviews: (1) Perceived need for the TIC training, (2) Perspective shift in patient care, (3) Increased support for staff wellness, (4) Importance of equal involvement of staff at all levels, (5) Need for leadership buy-in, and (6) Lack of self-efficacy and empowerment to train others.

Conclusions: A trauma-informed environment in a healthcare setting can bolster patient-centered care as well as a culture of staff wellness. This qualitative evaluation revealed that after TIC training, Trainers had improved attitudes and behaviors to commit to organizational TIC transformation to prevent unintended consequences of trauma for both patients and staff. Trainers' experiences with and suggestions for enhancing the TIC training should be considered for training future cohorts as they continue to strive for TIC transformation in their health centers.