Table 3.
Changes in readiness and capacity for trauma-informed care in years 1, 3, and 5 of CONCEPT implementation
| TSRT-SF domain | Year 1 | Year 3 | Year 5 | Time model | Time 1–2 Effect [95% CI] | Time 2–3 Effect [95% CI] | |||
|---|---|---|---|---|---|---|---|---|---|
| M | SE | M | SE | M | SE | ||||
| 1. Trauma training exposure | 3.80a | 0.06 | 4.19b | 0.04 | 4.15b | 0.06 | F = 12.66, p < .001 | 0.39 [0.25–0.53] | −0.04 [−0.19–0.12] |
| 2. Individual trauma knowledge and practice | 3.47a | 0.05 | 3.89b | 0.05 | 4.02b | 0.05 | F = 20.56, p < .001 | 0.42 [0.27–0.57] | 0.14 [−0.02–0.29] |
| 3. Staff trauma knowledge | 3.67a | 0.04 | 3.99b | 0.05 | 4.02b | 0.06 | F = 15.37, p < .001 | 0.32 [0.17–0.48] | 0.02 [−0.14–0.19] |
| 4. Staff trauma practice | 3.62a | 0.05 | 3.81b | 0.04 | 3.91b | 0.03 | F = 5.00, p = .007 | 0.19 [0.04–0.34] | 0.09 [−0.04–0.22] |
| 5. Trauma supervision and support | 2.48a | 0.08 | 3.04b | 0.07 | 3.08b | 0.06 | F = 10.88, p < .001 | 0.57 [0.33–0.80] | 0.03 [−0.15–0.22] |
| 6. Staff supports child relationships | 3.57a | 0.05 | 3.82b | 0.05 | 3.85b | 0.04 | F = 15.65, p < .001 | 0.24 [0.08–0.41] | 0.03 [−0.11–0.17] |
| 7. Birth families trauma support | 2.76a | 0.06 | 3.30b | 0.06 | 3.30b | 0.05 | F = 37.71, p < .001 | 0.54 [0.36–0.72] | 0.00 [−0.21–0.21] |
| 8. Resource family trauma support | 2.96a | 0.05 | 3.47b | 0.04 | 3.53b | 0.05 | F = 15.67, p < .001 | 0.52 [0.38–0.66] | 0.06 [−0.06–0.18] |
| 9. Staff address child psychological safety | 3.60a | 0.06 | 3.73a,b | 0.05 | 3.84b | 0.05 | F = 5.22, p = .006 | 0.13 [−0.04–0.30] | 0.11 [−0.06–0.29] |
| 10. Agency trauma assessment | 3.28a | 0.07 | 3.68b | 0.06 | 3.69b | 0.05 | F = 7.61, p = .001 | 0.39 [0.20–0.58] | 0.02 [−0.15–0.18] |
| 11. Access to trauma-informed services | 2.47a | 0.09 | 3.00b | 0.06 | 3.15b | 0.08 | F = 7.06, p = .001 | 0.53 [0.29–0.76] | 0.14 [−0.01–0.30] |
| 12. Local agency collaboration (general) | 3.45a | 0.03 | 3.48a | 0.04 | 3.62b | 0.05 | F = 2.04, p = .13 | 0.02 [−0.10–0.14] | 0.14 [0.01–0.27] |
| 13. Local agency collaboration (trauma) | 3.33a | 0.06 | 3.65b | 0.04 | 3.83c | 0.05 | F = 16.02, p < .001 | 0.32 [0.15–0.50] | 0.18 [0.03–0.33] |
Cells with different superscripts (within row) differ statistically from one another, p < .05.
a
Time model refers to overall linear effect of time assessed via regression with robust standard errors to adjust for clustering by area office/facility. All models controlled for years in child welfare field and role (manager/director and clinician/frontline staff positions); df reflects number of setting clusters (4,18).