Creating Innovative Trauma Programs with Participatory Research and Community Stakeholders
By Brandon Martinez, Research Associate
An evaluation team at the Center for Complex Trauma is using a community-based participatory research approach to understand how the Center for Trauma Innovation in East Harlem implemented a unique trauma-informed program.
Effective, efficient, and culturally competent programs are an important part of how community-based organizations (CBOs) serve their communities. For researchers, one approach for understanding CBOs is community-based participatory research (CBPR) methods – which allows organizations, researchers, and other stakeholders to equitably contribute to the research process. Using CBPR when evaluating these programs provides researchers, programs, and participants with the tools to enhance their understandings of program implementation and effectiveness. Through collaboration with project stakeholders, researchers can better center community perspectives and more accurately interpret their findings to provide programs with strategies for sustaining and strengthening programming.
An evaluation team at the Center for Complex Trauma (CCT) at Icahn School of Medicine is adopting a CBPR approach in its evaluation of the Exodus Center for Trauma Innovation—an innovative, trauma-informed program in East Harlem. Based on collaborative and stakeholder-centered methods, the evaluation team examined how the program implemented a unique approach that supports participants’ healing journeys. In a recently published report, the team detailed findings about the implementation of the program.
For more information about CCT’s ongoing evaluation of the CTI, visit the CTI Evaluation page and see the latest process report.
Implementing a Participatory Evaluation using Community-Based Participatory Research
In 2017, Exodus Transitional Community (ETC) was funded by the Criminal Justice Investment Initiative (CJII)—a partnership between CUNY ISLG and the Manhattan District Attorney’s Office—to develop the Center for Trauma Innovation (CTI). The CTI serves participants who have experienced chronic trauma related to incarceration, poverty, racism, community violence, and other events. It does so through three core prongs: direct services, training and technical assistance, and a learning community. As part of the CJII funding, the CCT used CBPR to examine these three prongs, actively working with CTI program staff, participants, community members, and funders to understand strengths and challenges as implementation was happening.
Participatory research approaches can be used to better interpret findings, understand challenges, and develop practical solutions together. Throughout their evaluation, CCT centered community knowledge and perspectives, which they used to support to CTI’s implementation by identifying participant needs, understanding the impact of incarceration and criminal-legal system-related trauma, building data infrastructure, and supporting data collection. Some of their methods include:
Establishing partnerships by meeting weekly with CTI staff to discuss shared goals and values, plan evaluation methods, report interim findings, and understand implementation successes and challenges.
Developing instruments to measure implementation and participant impact through a shared understanding of incarceration-related trauma and healing journeys.
Building rapport with participants through their continuous presence at the CTI.
Collecting data through staff and participant interviews and focus groups organized around pre-existing program scheduling.
Presenting findings to program staff to center the interpretive perspectives of clinical staff, previously incarcerated individuals, and participants.
Hiring a researcher with lived experience in the criminal-legal system.
Identifying Challenges and Strategies for Strengthening and Sustaining the Program
CBPR is particularly useful in helping researchers and stakeholders identify ongoing challenges and solutions during program implementation. This benefit is due, in part, to its focus on centering the interpretations of stakeholders and the role they play in guiding research practices. Through their evaluation of the CTI, CCT worked with these stakeholders to identify implementation challenges and develop ways to address them to enhance the program and support its staff and participants. Findings from interviews and focus groups were particularly useful in understanding opportunities to strengthen the program.
ADDRESSING INCARCERATION-RELATED TRAUMA AMONG STAFF AND PARTICIPANTS
Because the impacts of incarceration and criminal-legal system involvement extend beyond individuals to their friends, families, and communities, CTI staff and participants highlighted the need for additional family-focused services. The evaluation also identified a need for additional staff training to provide staff with the tools to deliver trauma-informed services that address the complex challenges faced by individuals impacted by the criminal legal system. Staff with lived experience of the criminal legal system can experience vicarious traumatization and compassion fatigue as a result of working with participants who are also experiencing its effects. As such, the evaluation highlighted a need for the organization to be aware of staff trauma and reduce burnout and turnover. Addressed holistically, these solutions could provide a better experience and more supportive healing journeys for participants, staff, and community members.
MAINTAINING FLEXIBILITY IN APPLIED DATA COLLECTION SETTINGS
Quality data collection is an important aspect of program implementation because it informs the program of successes and challenges while providing insights about the participant population. In practice, however, collecting data related to trauma-healing among justice-impacted individuals poses unique challenges. Ensuring that data are collected in a consistent and trauma-informed manner is also important for researchers working to understand the impact of programs. Some challenges the CTI faced include:
Maintaining consistent data collection processes in the face of staff turnover, programmatic changes, and facility relocations.
Balancing the need for comprehensive data with the comfort of participants answering trauma-related prompts and the bandwidth of staff administering questionnaires.
Adhering to standard follow-up processes and cadences to assess changes in trauma symptomatology and healing among participants.
Developing qualitative instruments that are sensitive to the context in which participants’ trauma is addressed and their healing is processed.
Using traditional outreach when coordinating data collection such as interviews and focus groups with a participant population’s shifting schedules and diverse commitments.
ADDRESSING DATA CHALLENGES THROUGH COLLABORATIVE PERSPECTIVES
To address many of these challenges, CCT, in collaboration with the CTI, identified several recommendations to enhance data collection that can also be useful for other programs and evaluation teams. First, data collection approaches should be flexible and adaptable to changes in implementation, service delivery, staff bandwidth, and participant needs. This may include changes to protocols, data collection approaches, and staff training. Establishing a flexible and collaborative approach ensures that data can be regularly collected while methodologies are refined and improved. For example, as a result of the evaluation findings, the CTI revisited and revised its data collection strategy for healing measures to better understand how its approach and services impact participants.
Second, researchers must work with program and clinical staff to develop tools that accurately reflect the complex nature of trauma and healing. Although quantitative measures can be used to describe discrete measures of and changes to symptomatology, the healing impacts of services likely extend to many different aspects of participants’ lives, relationships, and contexts that are not reflected in, or able to be captured by, existing quantitative measures.
Finally, evaluation teams should adopt participant-centered data collection strategies that can sufficiently accommodate their diverse and complex needs and availabilities. This may include providing virtual interview options, conducting focus group outreach in real-time, and providing participation incentives that reflect the importance of their time.
The CTI and CCT teams are currently collaborating to understand the program’s impact on participants and share evaluation findings for other programs and researchers. For more information about the CCT evaluation of the CTI, visit the CTI Evaluation page.
About the Criminal Justice Investment Initiative
Under former Manhattan District Attorney Cy R. Vance, Jr., the Manhattan District Attorney’s Office created the Criminal Justice Investment Initiative (CJII) in order to use $250 million seized in international financial crime prosecutions to invest in transformative projects that will improve public safety, prevent crime, and promote a fair and efficient justice system. CJII is a first-of-its-kind effort to support innovative community projects that fill critical gaps and needs in New York City’s criminal legal system infrastructure.
CJII focuses on three investment areas—crime prevention, diversion and reentry, and supports for survivors of crime. The CUNY Institute for State & Local Governance manages and provides technical assistance to CJII contractors, and conducts oversight and performance measurement throughout the lifetime of the initiative.
Image by Cultura Creative on Adobe Stock.