Pre-implementation Stage Research to Guide Trauma-Informed Care for Youth With HIV in the Southern US: A Multimethod Study.

BackgroundYouth with HIV disproportionately experience psychological trauma, but implementation methods for trauma-informed care are lacking.MethodsTo identify potential processes and determinants of trauma-informed care implementation, we conducted process mapping and qualitative interviews and thematically applied the organizational trauma resilience framework to elicit perceived safety, stability, and nurturance in a pediatric HIV clinic.ResultsForty-three personnel and 8 patient representatives engaged in process mapping; 20 completed qualitative interviews. Clinic culture was described as supportive, cohesive, and equity-focused, but requiring workflow improvements for patient autonomy. Trauma screening, assessment, and interventions were limited/inconsistently applied, with duplicative risk assessments. Support for professional quality of life was limited, despite burnout/attrition reports. Some personnel had trauma-focused training, but ongoing education and culturally responsive policies were needed.ConclusionsProcess mapping presented as a low-burden tool for unveiling gaps and care standards; alongside qualitative interviews, these methods provided practical insights for trauma-informed HIV care.