Primary Care Patients with Trauma History: Expanding a "Safety" Research Partnership and Network

Background: Since October 2017, five individuals who have lived through traumatic events and five professionals have created the Safety Partnership, meeting monthly to address the needs of primary care patients with trauma histories. Trauma is common and toxic among primary care patients, and few primary care providers are addressing trauma, although they have far-reaching potential. To plan, conduct, and disseminate comparative clinical effectiveness research (CER) that addresses this healthcare problem, the team wants to engage an expanded stakeholder network. A particular challenge is that trauma survivors often feel unsafe and disempowered, which could lead them to not participate or express themselves with confidence.

Solution: The project team has been identifying potential solutions for future CER, focusing on evidence-based trauma interventions for primary care settings. The team’s solution to address the capacity needs focuses on engaging, formalizing, preparing, and building infrastructure to collaborate with more stakeholders.

Objectives: The team’s three aims are to: expand and strengthen relationships with its partnership and larger networks; prepare partners and networks to engage and collaborate in patient-centered outcomes research  (PCOR), CER, and strategies that create a safe, engaging environment for trauma survivors; and establish infrastructure to sustain relationships, engagement, and collaboration, in order to prepare for planning CER. Achieving these aims will result in a sustainable partnership and collaborative that involves trauma survivors meaningfully in all phases of the research.

Activities: The project team will:

• Engage and strengthen relationships with seven new partners (three male/other gender patients, psychiatrist, substance use provider, healthcare administrator, coordinator), six networks (patient, primary care, trauma/behavioral health), and an advocate from each network
• Conduct in-person training with new partners and advocates (using existing PCOR/CER materials and the team’s trauma materials) and replicate training with at least six members per network
• Develop the Safety Collaborative, based on survey input and advocates’ involvement, to include an online platform for ongoing communication and sustainability plan for 12+ months of collaboration after the award ends

Outcomes: The team will be prepared to design CER that primary care patients will experience as safe, relevant, and matching their values and priorities, and that providers will experience as feasible and acceptable. The team will also be ready to actually conduct CER, with multiple primary care practices and networks ready to implement and evaluate interventions in their settings and the infrastructure to sustain relationships and collaboration. Tangible outputs include safety training materials, results from partner and stakeholder evaluations, online platform, and sustainability plan.

Engagement Plan: Five patients have been partners from the beginning and helped prepare this proposal. The team will continue to meet monthly, add new partners and stakeholder networks (five already committed), evaluate partnership and stakeholder functioning, and follow safety practices. Network leaders and advocates will facilitate members’ engagement with the team’s training, survey, and collaborative.

Collaborators: The University of South Florida, Crisis Center of Tampa Bay, National Association on Mental Illness-Florida, University of Florida H. James Free Center for Primary Care Education and Innovation, and Central Florida Behavioral Health Network.