Trauma Interventions for Low-income Women in PrimaryCare

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DESCRIPTION (provided by applicant): Trauma exposure and trauma-related mental disorders make substantial contributions to widely recognized health disparities in the U. S. Because low-income populations have little access to mental health specialty care and often find it stigmatizing, and because attention to mental health issues in primary care settings is limited, their trauma-related problems receive little if any professional attention. The goal of the Center for Trauma Interventions in Primary Care (C-TIP) is to develop innovative and sustainable interventions to address the spectrum of trauma-related mental health needs presenting to primary care settings serving low-income, mostly minority populations through academic-community research partnerships with local jurisdictions. To increase the adoption and sustainability of these interventions, the trauma-related services to be developed are being conceptualized in close collaboration with three highly invested community partners: the Department of Health in Prince George's County, MD; the Primary Care Coalition in Montgomery County, MD; and Unity Health Care, Inc. in the District of Columbia. The Center will extend the high quality research our Research Infrastructure Support Program (RISP) has already generated in this under-studied population by active collaboration with new academic partners: Georgetown's School of Nursing and Health Studies and its Department of Family Medicine. The Center's work will be conducted through three cores (Operations, Research Methods, and Principal Research) providing administrative oversight, statistical support, and access to expert advisory groups; innovative methods/research designs integrating perspectives from applied anthropology and public health; and expertise and support for the development of promising research. C-TIP funded research projects include: 1) a series of qualitative ethnographic studies describing relevant dimensions of the health care systems and clinical settings in which the work will take place; 2) a methods study evaluating the feasibility and acceptability of three strategies of recruitment and two strategies of retention of participants to trauma-related intervention research; and 3) a pilot study of a trauma-focused group intervention delivered by nursing personnel. The working partnerships and infrastructure capability that will be continued and fostered through C-TIP will allow us to develop comprehensive trauma intervention models whose translation to settings serving low income individuals we propose to study through an advanced center and other grant mechanisms.