title: Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training.
abstract: Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n= 17; 2 sites) or community physicians (n= 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.
authors.affiliation: Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA.
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Green
authors.affiliation: Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA ; Department of Neurology, Georgetown University Medical School, Washington, DC, USA.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Saunders
authors.affiliation: EPower & Associates, Nashville, Tennessee, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Power
authors.affiliation: Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Dass-Brailsford
authors.affiliation: University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA.
authors.forename: Kavitha Bhat
authors.initials: KB
authors.lastname: Schelbert
authors.affiliation: Sidran Institute, Baltimore, Maryland, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Giller
authors.affiliation: Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Wissow
authors.affiliation: Department of Oncology, Georgetown University Medical School, Washington, DC, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Hurtado de Mendoza
authors.affiliation: Department of Psychiatry, MedStar Health Research Institute, Hyattsville, Maryland, USA.
authors.forename: Mihriye
authors.initials: M
authors.lastname: Mete
keywords: Communication; continuing medical education; patient-centeredness; primary care; trauma