Trauma-Informed Principles in Practice: A Mixed-Method Study of Co-Producing Systems Change With People Who Have Experienced Multiple Disadvantage.
| Title: | Trauma-Informed Principles in Practice: A Mixed-Method Study of Co-Producing Systems Change With People Who Have Experienced Multiple Disadvantage. |
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| Authors: | Stone T; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Eyles E; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Traub T; Independent Futures, Changing Futures, Bristol, UK.; Burrowes J; Independent Futures, Changing Futures, Bristol, UK.; Halsley R; Independent Futures, Changing Futures, Bristol, UK.; S J M; Independent Futures, Changing Futures, Bristol, UK.; Gillam J; Independent Futures, Changing Futures, Bristol, UK.; Redaniel MT; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; National Cancer Registry Ireland, Cork, Ireland.; Redwood S; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.; Totti C; Independent Futures, Changing Futures, Bristol, UK.; Smith T; Independent Futures, Changing Futures, Bristol, UK.; Farr M; The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. |
| Source: | Health expectations : an international journal of public participation in health care and health policy [Health Expect] 2025 Dec; Vol. 28 (6), pp. e70472. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Wiley Country of Publication: England NLM ID: 9815926 Publication Model: Print Cited Medium: Internet ISSN: 1369-7625 (Electronic) Linking ISSN: 13696513 NLM ISO Abbreviation: Health Expect Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Wiley, c1998- |
| MeSH Terms: | Ill-Housed Persons*/psychology ; Vulnerable Populations*/psychology ; Social Work*/organization & administration; Humans ; Interviews as Topic ; Qualitative Research ; Female ; Surveys and Questionnaires ; Male |
| Abstract: | Background: Health and social care services increasingly recognise the value of involving people with lived experience in service design and delivery. For people who have experienced multiple disadvantage (combinations of homelessness, mental ill health, addiction, involvement with the criminal justice systems or domestic violence/abuse), participating in professional settings may be challenging and can risk re-traumatisation and greater disillusionment. However, gaining confidence and competency to do this offers opportunities for personal and professional development, contributing to meaningful change. It is necessary that individuals with lived experience can engage safely and effectively in these settings. This study analyses how an organisation of people who have experienced multiple disadvantage, Independent Futures (IF), enabled co-production within services and systems, to understand how people can be best supported and how involvement impacts them.; Methods: Sixteen IF members and three IF staff participated in semi-structured interviews. A staff survey, at two time points, investigated how employees from Changing Futures partner organisations perceived their ability to embed co-production within services, with 147 responses. Internal documentation was analysed to illustrate the diversity of co-production work that IF contributed to.; Results: Putting trauma-informed principles into practice facilitated personal growth, improved confidence and some work skills for IF members, who contributed to 65 different workstreams. However, embedding co-production into wider services and systems proved challenging. Staff survey comments highlighted obstacles related to resources, time and hierarchical cultures.; Conclusion: Lived experience organisations can model trauma-informed practice and influence systems. Embedding trauma-informed principles requires flexibility, openness and willingness that is sustainable only when everyone adopts and commits to these principles. Any evidence of tokenism destroys trust and undermines the endeavour.; Public Contribution Statement: This study was co-produced with people with lived experience of multiple disadvantage and staff participants. Two lived experience IF members were involved in: developing the funding bid, designing the research including designing the staff survey, developing interview topic guides, commenting on information sheets and developing interview arrangements to ensure comfort and safety of IF members. Four lived experience IF members and three members of staff contributed to writing the paper, including reviewing key literature, refining the analysis and developing the discussion and conclusion.; (© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.) |
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| Grant Information: | This study was funded by the National Institute for Health and Care Research (NIHR) Three Research Schools Mental Health Practice Evaluation Scheme Grant Reference Number: MH021. For information, the wider Changing Futures Programme was funded by the Department of Levelling Up, Housing and Communities (now the Ministry of Housing, Communities and Local Government of the United Kingdom), which includes funding for Independent Futures. This study was supported by the NIHR Applied Research Collaboration (ARC) West. |
| Contributed Indexing: | Keywords: co‐production; multiple disadvantage; systems change; trauma‐informed practice |
| Entry Date(s): | Date Created: 20251103 Date Completed: 20251103 Latest Revision: 20260521 |
| Update Code: | 20260521 |
| PubMed Central ID: | PMC12580506 |
| DOI: | 10.1111/hex.70472 |
| PMID: | 41178210 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't