Development and Evaluation of Two Integrated Care Models for Children Using a Partnered Formative Evaluation Approach.

Objective: To describe the development and evaluation of two integrated care models using a partnered formative evaluation approach across a private foundation, clinic leaders, providers and staff, and a university-based research center. Design: Retrospective cohort study using multiple data sources. Setting: Two federal qualified health care centers serving low-income children and families in Chicago. Participants: Private foundation, clinic and academic partners. Interventions: Development of two integrated care models and partnered evaluation design. Main Outcome Measures: Accomplishments and early lessons learned. Results: Together, the foundation-clinic-academic partners worked to include best practices in two integrated care models for children while developing the evaluation design. A shared data collection approach, which empowered the clinic partners to collect data using a web-based tool for a prospective longitudinal cohort study, was also created. Conclusion: Across three formative evaluation stages, the foundation, clinic, and academic partners continued to reach beyond their respective traditional roles of project oversight, clinical service, and research as adjustments were collectively made to accommodate barriers and unanticipated events. Together, an innovative shared data collection approach was developed that extends partnered research to include data collection being led by the clinic partners and supported by the technical resources of a university-based research center.

Complex trauma exposure and symptoms in urban traumatized children: a preliminary test of proposed criteria for developmental trauma disorder.

Recently, a new diagnostic construct, developmental trauma disorder (DTD), was proposed to describe the effects of chronic exposure to violence in combination with disruptions in caregiving systems. This study uses archival data to field test the consensus proposed diagnostic criteria for DTD in a sample of urban children (N = 214). Children with complex trauma histories as defined in the proposed DTD Criterion A were much more likely to meet the proposed DTD symptom criteria than children who did not meet the exposure criterion. This field trial of the proposed DTD criteria suggests that the proposed construct of DTD is useful for describing the symptoms induced by ongoing traumatic stressors and disrupted caregiving and that the proposed symptom criteria can differentiate children with histories of exposure to developmental trauma from other trauma-exposed children.