Objective: As organizations strive to build trauma-informed care (TIC) systems, further understanding of individual and organizational characteristics that may impact implementation is needed. The objective of this study was to assess changes in affective commitment, beliefs, foundational knowledge, and selfefficacy following completion of a TIC curriculum for a group of interprofessional pediatric service providers. Understanding effects of training on the perceptions of organizational support held by participants was also central to our inquiry. Method: A quasi-experimental pre/post design was used to assess the effectiveness of a curriculum comprising a required prereading component and a 4-hour interactive educational experience. The in-person session was designed to prompt a full appreciation of the impact of traumatic events on brain development and the long-term consequences of traumatic stress and historical trauma. Professionals recruited from several Midwestern pediatric service organizations completed pre-and posteducation surveys, answering questions on the Affective Commitment to TIC scale, Beliefs about Trauma subscale, Foundational Knowledge subscale, Principal Support for TIC, and TIC Self-Efficacy subscale. Results: Findings suggest that the proposed TIC curriculum effectively increased participants' TIC beliefs, knowledge, and self-efficacy as well as their perceptions of organizational support. Conclusions: We propose that TIC trainings tailored to the specific needs of the target audience hold potential toward promoting systemic organizational change among pediatric agencies.
Clinical Impact StatementGrowth, development, and adaptive behaviors can be disrupted in children through adverse childhood experiences. Trauma-informed care (TIC) approaches are essential to educational, social welfare, medical, and mental health system interventions, but poorly organized systems that silo professionals and stratify institutional structures remain barriers to the delivery of TIC. The study implemented training emphasizing culturally focused TIC perspectives to affect changes in affective commitment, beliefs, knowledge, and self-efficacy among an interprofessional group of pediatric service providers. Improvements were noted in all variables. The training showed promise in influencing organizational change through heightened perceptions of organizational support and improved self-efficacy.
BACKGROUND Critical healthcare issues are impacting society. Interprofessional learning must be designed to match this complexity.
PURPOSEWe designed and implemented multiple interprofessional learning activities to address serious topics in health care to determine if learning experiences founded on critical health issues resulted in increased knowledge among the interprofessional team of learners. METHOD This was an observational, cross-sectional cohort study. Participants were students enrolled in health science and medical programs at a university in the Midwest U.S. Learning activities consisted of journal club, Pain C.A.R.E., poverty simulation, or Strategies for Health.
RESULTSOutcomes for student learning indicated strong agreement on teamwork variables. Faculty involvement sustained the implementation of interprofessional learning experiences.CONCLUSION Addressing social determinants of health as the learning content of an interprofessional learning activity was an effective method for increasing students' confidence and comfort within an interdisciplinary team.
Anticipating the number of hospital beds needed for patients with COVID-19 remains a challenge. Early efforts to predict hospital bed needs focused on deriving predictions from SIR models, largely at the level of countries, provinces, or states. In the USA, these models rely on data reported by state health agencies. However, predicting disease and hospitalization dynamics at the state level is complicated by geographic variation in disease parameters. In addition, it is difficult to make forecasts early in a pandemic due to minimal data. Bayesian approaches that allow models to be specified with informed prior information from areas that have already completed a disease curve can serve as prior estimates for areas that are beginning their curve. Here, a Bayesian non-linear regression (Weibull function) was used to forecast cumulative and active COVID-19 hospitalizations for SD, USA, based on data available up to 2020-07-22. As expected, early forecasts were dominated by prior information, which was derived from New York City. Importantly, hospitalization trends differed within South Dakota due to early peaks in an urban area, followed by later peaks in rural areas of the state. Combining these trends led to altered forecasts with relevant policy implications.
Supplementary Information
The online version contains supplementary material available at 10.1007/s41666-021-00094-8.
Social and health inequities among communities of color are deeply embedded in the United States and were exacerbated by the COVID-19 pandemic. Community-based participatory research (CBPR) is a powerful approach to advance health equity. However, emergencies both as global as a pandemic or as local as a forest fire have the power to interrupt research programs and weaken community relationships. Drawing from Public Health Critical Race Praxis (PHCRP), as well as our research experience during the pandemic, this article proposes an expansion of prior CBPR principles with an emphasis on advocacy and storytelling, community investment, and flexibility. The article summarizes key principles of CBPR and PHCRP, contextualizes their relevance in COVID-19, and outlines a practical vision for crisis-resilient research through deeper engagement with antiracism scholarship. Structural barriers remain an issue, so policy changes to funding and research institutions are recommended, as well, to truly advance health equity.
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