A Mixed Methods Exploratory Assessment of the Usefulness of Baltimore City Health Department's Trauma-Informed Care Training Intervention

Youth exposure to trauma is a significant public health problem in the United States, particularly in urban areas. Although trauma-informed care (TIC) training of service providers to address this challenge is increasing nationwide, we lack empirical evidence regarding the feasibility and acceptability of cross-organizational TIC training, including perspectives of training participants. The purpose of our study was to evaluate participating service providers' self-reported changes in knowledge about trauma, attitudes toward traumatized individuals, and beliefs in their capacity to provide referrals to trauma services after completion of the TIC intervention. Intervention participants represented a range of service sectors, including government health and education agencies, social services, law enforcement, as well as nonprofits. Participants completed a pre post quantitative survey assessing TIC-related knowledge, attitudes, and beliefs (N = 88). A subset of participants was interviewed using a semistructured interview format (n = 16). Mixed methods were used to evaluate the intervention's impact on participants' knowledge about trauma and to understand participants' experience in the training. Quantitative results revealed significant improvements in TIC-related knowledge and attitudes. Five themes emerged from qualitative analysis of interviews: the intervention provided a framework for understanding TIC; useful lessons were learned from other participants; there was a need for outreach to upper-level management; real life applicability was lacking; and guidance regarding next steps was wanting. Study findings suggest the training may he a starting point for enhancing service providers' capacity to address traumatized youth. Public Policy Relevance Statement Youth exposure to trauma is a highly prevalent public health issue in the United States, particularly in urban communities. This study suggests policies that support trauma-informed care training may help service providers from different sectors potentially including law enforcement, health, education, and nonprofits develop greater understanding of the signs and impact of trauma and capacity to link the youth they serve with trauma services.