Work

Trauma-informed care implementation in Texas community health centers: Results of organizational assessments.

Year: 2026

Type: article

Abstract: Objective: Trauma-informed care (TIC) recognizes the impact of trauma on health and is suitable for implementation in health care settings to foster improved staff and patient outcomes.We examined the interim impact of a TIC initiative on health center-wide organizational transformation into trauma-informed environments.Method: We used a longitudinal observational design to analyze the effectiveness of the TIC initiative.Before TIC initiation and at specified intervals afterward, all staff in five cohorts of participating health centers completed an organizational assessment survey comprising various domains related to TIC practices.We evaluated aggregated subdomain-level changes using linear mixed-effects models, using time points as fixed effects and cohorts as random effects.Results: Compared to baseline, the TIC initiative produced large significant improvements in the subdomains: training and education; offering services and trauma-specific interventions; staff supervision, support, and self-care; and reviewing policies.We observed moderate significant improvements in the subdomains of conducting intake assessments, creating written policies, establishing a safe physical environment, establishing a supportive environment, and developing goals and plans.We observed no statistically significant change in the subdomain of involving current and former patients.Conclusions: Health centers made substantial changes in staff support and service delivery postinitiation of TIC training.However, patient involvement in the development of TIC-related practices and policies remained a challenge, highlighting the need for long-term commitment to TIC to solidify organizational transformation.As health centers continue to strengthen and refine their TIC strategies, ongoing assessment, adaptation, and resource allocation will be essential to sustain positive staff and patient outcomes. Clinical Impact StatementGiven the high prevalence of trauma and its deleterious impact on chronic and mental health conditions, trauma-informed care (TIC) is a promising preventive framework that can be integrated into health care settings to improve patient health outcomes and workforce retention.Sustained, organization-wide implementation of TIC is essential to transform the health care environment into one that promptly recognizes and responds to trauma, supporting long-term positive outcomes.Findings suggest that the TIC program was effective in strengthening foundational education on TIC principles, fostering a culture of staff wellness, delivering trauma-specific interventions, and developing and revising policies to support trauma-informed practices.

Source: Psychological Trauma Theory Research Practice and Policy

DOI: 10.1037/tra0002151