The goal of this fellowship is to prepare the applicant, April Joy G. Damian, for an academic research career focused on improving access of urban youth with histories of childhood adversities to treatment and social support systems that promote healthy coping and social-emotional functioning. To that end, the proposed fellowship consists of two complementary components: 1) a research project evaluating knowledge, attitudes, and behavior outcomes, including referral rates, associated with the Baltimore City Health Department Trauma-Informed Care (BCHD TIC) Initiative; and 2) a training plan comprised of formal coursework, mentorship, and didactic as well as professional development activities.
The Specific Aims of the research project are to conduct a prospective cohort study, using preexisting quantitative data gathered from 120 individuals (ages 18 to 65 years) and qualitative data from 30 individuals (ages 18 to 65 years) from youth- serving government agencies and nonprofit organizations being trained in the BCHD TIC Initiative, to examine one year pre-post changes in: 1) self-reported knowledge, attitudes, and beliefs about trauma services, and professional quality of life, of agency personnel; 2) organizational- and provider-level factors associated with implementation of trauma-informed care from the perspective of agency personnel (assessed via the organizational TIC self-assessments; SAMHSA, 2014); and, 3) referral rates of traumatized youth to appropriate services. This study marks the first formal scientific assessment of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) trauma-informed care training model, despite growing implementation throughout the U.S. One explanation for the proliferation of TIC trainings nationwide, even in the face of limited evidence, is the growing understanding of the high prevalence of adverse childhood experiences, and the limited mental health services and resources for individuals with a history of childhood trauma. Building evidence around the BCHD TIC initiative has important implications for improving outcomes for this population, who face numerous negative short- and long-term outcomes. Evidence gathered from this study will also be critical to substantiate funding for a future multisite randomized controlled trial of the BCHD TIC Initiative in other urban U.S. cities. This project is supported by a strong interdisciplinary mentorship team with expertise in trauma-informed interventions, positive youth development, implementation science, and mixed methods, and will take place in a world class research department and institution. The proposed fellowship will also provide Ms. Damian with the coursework, didactic opportunities, and professional relationships that she requires to progress to the next stage of her career as an independent researcher. Both the training plan and research project will prepare Ms. Damian to achieve her career objective of improving and evaluating trauma-informed service systems to support healthy youth development in communities with high rates of trauma exposure, consistent with the NICHD Scientific Vision: The Next Decade goals.
Despite high rates of adverse childhood experiences (ACES) and the known negative short- and long-term consequences of ACES throughout the lifespan, access to trauma-informed care services and support systems for traumatized youth is limited. The goal of the proposed research project is to evaluate the Baltimore City Health Department's Healing Baltimore Trauma-Informed Care Initiative, a training model for youth-serving government agencies and nonprofit organizations. The ultimate goal of the training plan, together with this project, is to promote effective and targeted interventions that connect youth with a history of ACEs to the appropriate mental and social support systems.
