Traumatic events are common occurrences in the lives of adults living in the United States. Roughly one quarter of those who experience a traumatic event will subsequently meet full criteria for posttraumatic stress disorder (PTSD);another quarter will experience partial PTSD with significant levels of Impairment. PTSD is related to adverse health outcomes. Including significant comorbidity with other behavioral health disorders, physical health disorders, and increased service utilization. Significantly less is known about trauma and trauma-related disorders including PTSD in American Indian and Alaska Native people (AI/ANs). Evidence suggests higher rates of trauma exposure and trauma-related disorders in AI/AN community and clinical samples than the general United States population. The health care setting offers a rich opportunity for the detection of trauma-related disorders. A high proportion of those experiencing a traumatic event receive health care services for injuries sustained or present for trauma-related sequelae even years after the event. The concept proposed is one of two related research projects within a renewal of the American Indian and ALaska Native Health Disparities center (P60) grant of the University of Colorado Denver. This research project builds upon existing studies examing behavioral health screening and detection in primary care settings for AI/AN people. Using a community based participatory approach, the proposed research project will engage key stakeholders In the consideration, development, and piloting of systematic screening for trauma among AI/AN adults at sites serving two unique AI/AN groups through the following specific alms: 1) Work with key stakeholders to consider and develop means to systematically screen for trauma then refer affected Individuals for intervention in two AI/AN health care settings;and 2) Pilot trauma screening and referral then assess the acceptability and feasibility of a future large scale trial in both settings.
The primary outcome of interest is the development of an AI/AN population based acceptable and feasibile trauma screening, intervention, and referral system for use in AI/AN primary care setting. In terms of acceptability, we are interested in the acceptability to patients, clinicians, and clinical, administrative, and tribal leadership. With respect to feasibility, we will assess challenges and benefits which emerge during screening. intervention, and referral activities.
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