105 - Using Organizational Assessments to Guide Trauma Informed Care Integration

Abstract Information: Research shows that people with HIV are disproportionately impacted by trauma, which can affect a client’s HIV care and treatment outcomes. Since 2019, CAI, a capacity-building organization, has led the New York TIC Initiative (NYTIC), supporting over 20 Federally Qualified Health Centers, Health Homes, and Syringe Service Providers in integrating trauma informed care (TIC) into their agency culture and physical space, and providing trauma services for clients. CAI’s TIC Implementation Model includes preparatory work early in the integration process, including the completion of a Cultural Assessment (CA) and a Physical Assessment (PA), designed by CAI and based on the core values of TIC described by SAMHSA. The PA focuses on safety while the CA also includes trustworthiness, support and respect, choice, collaboration and shared decision making, empowerment, and cultural, historical, and gender humility. Individuals across an agency are encouraged to complete the assessments including leadership, clinical staff, direct service staff, administrative staff, support staff and clients. Agencies are encouraged to involve other perspectives such as board members, interns, and volunteers. Engaging clients and a variety of staff in the assessment process allows CAI and the agency to better understand the current context and needs, helping to inform future technical assistance (TA). Agencies are also encouraged to complete annual reassessments to understand the extent that TIC is integrated, providing an opportunity for new staff to participate in the assessment process and allowing agencies to examine newly updated processes and/or systems through the TIC core values. Through February 2024, 1,536 staff and clients from 20 agencies have completed 26 Cultural Assessments and Reassessments. Additionally, 72 staff and clients at 12 agencies have completed 14 Physical Assessments and Reassessments. Upon completing an assessment, agencies review the findings and complete action plans to identify goals and tangible steps to take, the timeframe, person(s) responsible, and resources needed. In a 2023 survey completed by key staff who participate in TA at each agency, 100% of respondents reported that using the results from the CA and PA to develop agency-specific goals increased their ability to integrate TIC to a moderate or large extent. Agency updates that emerged from action planning include: updated job descriptions, orientation, and training for newly hired staff to support the integration of TIC principles throughout the agency culture; created a suggestion box to solicit staff feedback, leading to increased transparency between leadership and staff; updated flow of syringe exchange to ensure more privacy and ease of access for clients; and redesigned a drop-in room to be a space for clients to practice self-care. The TIC CA and PA are critical tools of CAI’s TIC Implementation Model and bring together a variety of perspectives that shape implementation activities. Understanding current TIC integration, informed by assessment results, supports the design of a customized TA plan that informs main implementation planning and activities.