Application of a Framework to Implement Trauma-Informed Care Throughout a Pediatric Health Care Network

Danielle Weiss, Nancy Kassam-Adams, Carol Murray, Kristen L. Kohser, Joel A. Fein, Flaura K. Winston, Meghan L. Marsac

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Introduction:To evaluate the initial application of a recently published three-step framework for implementing trauma-informed care (TIC) in a pediatric health care network by applying Framework for Spread.Methods:In steps 1 and 2 of the framework, we established commitment from the health care network leadership and initial interest in TIC among clinical providers (step 1), set evidence-based training goals and created the associated TIC training content (step 2). In step 3, 440 health care professionals (from 27 health care teams) participated in single-session, 1-hour training that covered the psychological impact of injury- and illness-related trauma, identification of traumatic stress symptoms, and how to respond to children exposed to potentially traumatic events. A concomitant quality improvement project allowed us to assess potential changes in training participants' favorable attitudes toward the integration of TIC and confidence in delivering TIC.Results:Compared with pretraining, participants demonstrated increases in attitude toward TIC, t(293) = 5.8, P <.001, Cohen's d = 0.32, and confidence in delivering TIC, t(293) = 20.9, P <.001, Cohen's d = 1.09.Discussion:Trainings were effective in achieving proximal goals targeting attitudes and confidence, thereby demonstrating the feasibility and clinical relevance of TIC training when implemented according to the three-step framework. Future research should examine methods of training to reach wide audiences to promote systematic change and evaluate changes in patient outcomes associated with providers' implementation of TIC.

Original languageEnglish
Pages (from-to)55-60
Number of pages6
JournalJournal of Continuing Education in the Health Professions
Issue number1
StatePublished - Dec 1 2017

Bibliographical note

Publisher Copyright:
© 2017 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.


  • changing perceptions in medical professionals
  • continuing education for health professionals
  • framework of training health care professionals
  • interprofessional education
  • knowledge translation
  • medical trauma
  • organization learning and change
  • patient safety
  • program planning/curriculum development
  • quality improvement/six sigma/lean
  • research/evaluation
  • trauma-informed care

ASJC Scopus subject areas

  • Education


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