Understanding Staff- and System-Level Contextual Factors Relevant to Trauma-Informed Care Implementation

Objective: Trauma-informed care (TIC) is increasingly used to address and prevent adverse childhood experiences. However, research on the implementation process of TIC has lagged, limiting its impact and sustainability. The goal of this two-study project was to provide a summary of staff- and system-level contextual factors relevant to TIC implementation. Method: Study 1 was a secondary data analysis of survey data from 760 staff members from human services, health, and education practice settings familiar with TIC. Independent-samples t tests were used to evaluate differences between lower- and higher-implementing organizations on staff- and system-level TIC implementation drivers. These drivers were then coded using the Consolidated Framework for Implementation Research (CFIR). Study 2 was a content analysis of the empirical literature on TIC. Study 2 produced information on the staff- and system-level facilitators of and barriers to TIC implementation. which were then also coded using the CFIR. Results: Study 1 suggested that the attributes of the individuals implementing TIC and the implementation climate of the organization played the most central roles. Study 2 identified available resources and the strength and quality of the evidence underpinning the intervention as important contextual factors for TIC implementation. Conclusion: This study used a well-established framework. the CFIR, to elucidate key contextual factors related to the successful implementation of TIC. with the goal of informing the efforts of researchers, practitioners, and policymakers.