PROJECT SUMMARY/ABSTRACT
Many evidence-based mental health interventions have been developed to address the negative outcomes
associated with child exposure to early adversity and trauma. Despite these promising advances, however,
the majority of children served in publicly funded mental health systems do not receive evidence-based
programs (EBPs). To address this research-to-practice gap, several large-scale, system-driven
implementation efforts of multiple trauma EBPs have been launched over the last decade, including in the
states of California and Arkansas. Though these system-driven initiatives often increase EBP delivery in
community settings following the initial implementation push, long-term sustainment of EBP delivery is low.
Workforce risk factors, such as provider burnout leading to turnover, have been identified as contributing to the
poor long-term sustainment of trauma EBPs. Therefore, an important step to consider in supporting the long-
term sustainment of child trauma EBPs is to develop implementation strategies that target provider burnout
and organizational climate factors associated with decreased provider retention.
This proposed K23 Mentored Patient-Oriented Research Career Development Award will develop and pilot a
package of implementation strategies, “Supporting Providers & Preventing the Overwhelming of Resources in
Trauma Systems” (SUPPORTS), aimed increasing the sustained delivery of trauma EBPs by addressing the
factors associated with provider retention related to burnout. The development of SUPPORTS will be informed
by a needs assessment conducted with programs involved with the multiple-EBP implementation efforts in
California and Arkansas. This project will build upon the applicant’s foundation of research and clinical
experience while also providing specialized training critical for the applicant’s future development. Specifically,
the applicant requires additional training in: 1) theory and practice in implementation science with particular
emphasis on organizational management and science as it pertains to the development and testing of
implementation strategies; 2) advanced methodologies, including qualitative and mixed qualitative and
quantitative methods; and 3) healthcare economic techniques to evaluate the impact of implementation
strategies. This training will be facilitated by mentorship from the applicant’s primary sponsor, Dr. Lauren
Brookman-Frazee, and her co-sponsors, Drs. Gregory Aarons, Todd Gilmer, Lisa Kath, and Allison Hamilton.
This project will provide pilot data to motivate a subsequent NIMH R01 application to conduct a large-scale trial
of the implementation strategies supporting the sustainment of child trauma EBPs. In addition, this project will
provide the applicant with the advanced training and skills required to launch an independent research
program focused on improving mental healthcare services for children exposed to early adversity and trauma.