Psychometric Evaluation of the TIC Grade, a Self-Report Measure to Assess Youth Perceptions of the Quality of Trauma-Informed Care They Received

Abstract

Background Agencies and clinical practices are beginning to provide trauma-informed care (TIC) to their clients. However, there are no measures to assess clients’ perceptions of and satisfaction with the TIC care they have received. A 20-item questionnaire, the TIC Grade, was developed, based on the National Center for Trauma-Informed Care principles of TIC, to assess the patient or client perception of the TIC provided in settings that serve adolescents and emerging adults. Objective The goal of this project was to evaluate the psychometric properties of the TIC Grade instrument and to make recommendations for use of the full measure and its short form—an overall letter grade. Study Design The TIC Grade questionnaire was administered to youth over the age of 18 years from four community partners providing care to vulnerable young adults. Potential participants were offered questionnaires at the end of their visit. Those interested in participating left their completed anonymous questionnaire in a locked box to maintain confidentiality. Questionnaires were collected from 100 respondents; 95 were complete enough to include in analyses for psychometric evaluation. Results The findings of this project support the reliability and usability of the 20-item TIC Grade measure to assess youth’s perceptions of the quality of TIC they received. Conclusions This TIC-specific, behaviorally worded client report measure can assist service delivery organizations to assess their success at implementing TIC and to identify areas where further staff training and support are needed.

Florida Trauma Responsive and Caring Environment: Exploratory Factor Analysis of a Staff and Youth Trauma-Informed Self-Assessment Tools in Juvenile Residential Programs

“…Its broad conceptualization of TIC perceptions, as captured by Trauma-Informed Environment (Factor 1), captures several distinct aspects such as treatment progress, social support, resource availability, and crisis planning. This resembles a previous client-oriented instrument-the TIC Grade (Boucher et al, 2020)-and may indicate that clients experienced TIC holistically. This contrasts with the TRACE's and prior instruments' more specific TIC domains that distinguish between training and specific trauma related practices (e.g., trauma screening and crisis planning).…”

“…However, prior instruments typically focus on client or staff perceptions independently. This study not only contributes to an underdeveloped but growing body of literature intent on adding client perceptions to measurements of TIC (Boucher et al, 2020; Goodman et al, 2016; Sinko et al, 2020) but also allows for research into congruence or disagreement between youth and staff. By these means, measuring TIC using responses from both perspectives provides a more holistic understanding of organizational culture and can yield insight into potential issues such as poor TIC implantation fidelity that produce perception differences between clients and staff.…”

Developing the TIC Grade: A Youth Self-Report Measure of Perceptions of Trauma-Informed Care

“…The CYAB's collaboration contributed to content validity for the resulting 20-item TIC Grade measure. The TIC Grade has since then been used by community partner organizations, and the forms have been used for psychometric assessment (Boucher et al, 2020). This measure has strong potential to fill an important gap in providing a means to represent youth service user's voices and perceptions to evaluate TIC.…”

“…This article reports the first step in a two-step project to collaborate with youth in the community to create a measure with strong content validity and then to psychometrically test this evaluation measure. A companion article (Boucher et al, 2020) also appears in this issue focusing on the psychometric testing across a handful of service organizations.…”