RESUMEN
Trauma-informed care (TIC) training may be valuable for patient-facing health care providers within primary care in urban health care settings serving patients with high levels of trauma exposure. This study tested the pilot effectiveness of a clinic-wide TIC initiative to enhance providers' knowledge, comfort in caring for trauma-exposed patients, and implementation of TIC within a primary care clinic of an urban safety net hospital using a single-arm longitudinal within-subjects design. Measures were obtained at baseline (T1), posttraining (T2), 1-month (T3), and 6-months (T4). Twenty-nine providers who completed TIC training were included in study analyses. Twenty-one completed T2 and 14 completed T3 and T4. Knowledge was measured with the Providers' Knowledge Regarding Injury-Related Posttraumatic Stress, comfort with a researcher-generated two-item measure, and TIC implementation with an eight-item binary scale from the Trauma Provider Survey. Repeated-measures general linear model examining within-subjects change over time in knowledge was significant (n = 8; F3 = 4.74, p = .01, ηp² = .40); the model measuring change in comfort was not significant but trending (n = 9; F3 = 4.56, p = .06). The model examining change in TIC implementation from T1 to T4 was not significant (n = 14; F3 = 4.32, p = .21). This pilot study demonstrated the preliminary effectiveness of a brief TIC training on improving health care provider knowledge and comfort working with trauma-exposed patients that sustained through 6-months posttraining. The findings indicate that additional support is needed to change behaviors in provider implementation of TIC in primary care clinic settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
RESUMEN
The COVID-19 pandemic has forced couples to navigate illness-related stressors and unique public health responses, including extended lockdowns. This study focused on under-resourced North Carolina residents (n = 107) who self-reported changes in relationship conflict (Increased, Decreased, Stayed the Same) and intimate partner violence (IPV) during the pandemic. We expected high rates of increased conflict and IPV since the start of the pandemic. We then sought to determine the associations between dyadic changes in conflict and reports of IPV and pandemic-related experiences and responses. Participants completed a brief online survey assessing their demographics, COVID-19 exposure/stressors, and pandemic responses. As expected, reports of increased couple conflict were related to difficulties getting needed social support, loss of health insurance, more fear and worry, stress, pain, and greater use of alcohol and/or illicit drugs, related to the coronavirus. Participants reporting increased conflict were also more likely to be unemployed. Conversely, reports of decreased conflict were associated with being ill from the virus (48.9%), having health insurance, and working part time. Substantial amounts of IPV were reported (62.2% of the sample); however, increased conflict and IPV were unrelated. Those reporting No IPV were less likely to be receiving public assistance but more likely to have home responsibilities due to the virus. They also reported increased social interactions and less use of alcohol than those reporting IPV perpetration. Findings highlight key associations among pandemic experiences and responses, IPV, and couple functioning in an under-resourced sample. Efforts to facilitate coping, resilience, and tolerating uncertainty may facilitate cooperative and safe couple functioning throughout the pandemic.