(Converted as ePoster, See Poster Gallery) Contextual Factors Supporting Treatment Completion Among Latinx Trauma Exposed Adults: Framing Needs to Support Trauma Informed Care in Community Based Mental Health Care

Background and Purpose: Low-income, urban Latinx populations experience trauma at higher rates and are less likely to seek and complete mental health treatment than non-Hispanic Whites, resulting in higher levels of psychosocial stressors and increased rates of diagnosed post-traumatic stress disorder (PTSD). Compounding these risks for Latinx populations are trends in delaying or avoiding care when in need due to stigma, inability to source and navigate care leading to disparities in mental health outcomes and impaired functioning. The study aims to investigate risk factors among vulnerable Latinx adults in the degree of adherence to treatment in relation to clinical complexity of trauma presentation and individual context when engaging in Trauma Informed Care (TIC) services. Informed by the Andersen health behavior model, the nature of the relationships between predisposing variables (age, gender, and years in the United States), enabling variables (characteristics of experienced violence), and need constructs (functional impairment) on the influence on TIC treatment completion are examined.

Methods: A secondary data analysis of patient level data collected from participants receiving outpatient community based care was completed (n = 336). Treatment completion was framed as participating in 8-12 TIC treatment sessions. Direct and moderating effects of predisposing variables on the relationship between need variables and TIC treatment completion were examined using stepwise logistic regression. Need variables examining functioning included Sheehan Disability Scale, SDS – Work and School; Social, Home-Family life and the WHO-QOL–Health, Psychological, Social Support, and Environmental domains.

The study sample met cut off criteria for PTSD (PCL-5 > 33; M = 45.9, S.D. = 18.7) and reported experiencing on average 4.87 (S.D. = 3.09) types of traumatic events in their lifetime, with assaultive crimes as the most common. By majority the sample identified as female (83%), Mexican (76%), reported as born outside of the United States (61.3%; Years in the U.S., M = 23.6, S. D. = 11.1), and approximately half reported speaking Spanish only (49.1%).

Results: Overall, 62.3% of individuals completed TIC services with at least 8+ sessions. Analysis revealed increased years residing in the United States (OR = 1.07, 95% CI = 1.02, 1.13) and self-reported disability in family-home responsibilities (SDS; OR = .801, 95% CI = 0.668, 0.960) were predictive of TIC treatment completion. No direct effects with other predisposing, enabling or need variables were present, however, a significant interaction resulted with the relationship between years in the U.S. and quality of life – psychological well-being (OR = .908, 95% CI = .962, .998) and environmental well-being (OR = 1.11, 95% CI = 1.01, 1.03).

Conclusion & Implications: Results suggest the need to emphasize resources in the treatment experience that help manage the impact of PTSD on multi-faceted daily life needs to support well-being, especially for non-U.S. born clients who may be less familiar with systems of care and have competing priorities in treatment needs. Promoting connections to alleviate stress around health, social support, and community can remove barriers to care and enhance perceived value of mental health treatment supporting treatment adherence.