Supporting Children and Families through Trauma: A Qualitative Exploration of Co-Creating Well-Being Capacity Building and Community Engagement

Background and Purpose: A significant corpus of research suggests unaddressed trauma and toxic stress can negatively affect key life outcomes such as perinatal experiences, child development, school readiness, and psychosocial and physical health. Trauma-informed care (TIC), human-centered design (HCD), and diversity, equity, and inclusion (DEI) practices can inspire participatory service redesign to address complex challenges. Co-Creating Well-Being (CCWB) is a five-year, multi-part initiative pioneered by a regional health foundation. Its goal is to support human service organizations to address trauma and toxic stress experienced by young children and their families through authentic partnership with their service recipients and communities.

Methods: To increase capacity of service providers across the region, CCWB participants were provided with training and technical support on TIC, HCD, and DEI principles. A stratified sampling frame was used to recruit past participants of the CCWB trainings and current grantees to complete in-depth interviews. Thirty-four participants were interviewed and qualitative thematic analysis was used to evaluate early effects of CCWB capacity building.

Results: Agencies’ pre-existing conditions were highly influential to their receptivity for incorporating CCWB principles and tools. These pre-existing conditions included the larger organizational culture and the regulatory and funding environments through which agencies navigated. These pre-existing conditions were directly related to the second category of receptivity to CCWB opportunities for change. Agencies were either receptive to the CCWB training and support or not, and their receptiveness dictated the extent to which the training and tools increased engagement, involvement, and partnership and helped them center the needs and experiences of their target population. When engaging with CCWB, another prominent category was adoption, which refers to the implementation of lessons and tools to increase HCD, TIC, and DEI. Even though some agencies felt that CCWB was important, there were COVID- and agency-related barriers that prevented further progress. Agencies who weathered the COVID-crisis and pivoted their CCWB/HCD plans were able to move to the next stage that produced early outcomes. Early outcomes are the positive results of moving through the entire process of change. These outcomes included becoming more human-centered and trauma-informed, advancing CCWB sustainability, seeking new opportunities using CCWB/HCD approaches, and other shifts in way the organizations operated. Two major macro-level factors influencing all aspects of the conceptual model are impact of COVID-19 and calls for racial justice accountability. The global pandemic was an unexpected crisis, whereas racial justice accountability issues have continued to be on the forefront across time. Both were impacting the agencies’ day-to-day work and CCWB engagement at varying levels.

Conclusions and Implications: Together, TIC, HCD, and DEI center the needs and experiences of vulnerable community members, and these approaches empower them to work with agencies to co-create innovative solutions to intractable health and well-being concerns. Early effects of the CCWB grant-making model may inspire educators, practitioners, and philanthropic organizations to engage in similarly bold capacity-building work. Additionally, to achieve desired outcomes, some conditions facilitating the implementation of CCWB need to be established, including supportive organizational, regulatory, and funding environments, and agency stability.