Effect of a trauma-informed care training program for a community care team working for young pregnant women: a...

Young maternal age (24 years or below) is a well-documented risk factor for child maltreatment. Young pregnant women are more likely than older mothers to have experienced childhood trauma, potentially increasing their vulnerability to re-traumatization during pregnancy and perinatal care interactions. Re-traumatization may play a role in increased child maltreatment risk, underscoring the importance of incorporating trauma-informed care (TIC) approaches into maternity services for this population. However, the implementation and evaluation of TIC training in community-based perinatal maternity care settings remain limited. As favorable staff attitudes are critical for the successful adoption and sustainability of TIC, evaluating the impact of training on professional attitudes is essential. We aimed to develop and evaluate the effects of a TIC training program on community-based maternity staff attitudes toward TIC in the Tokyo metropolitan area.

Fifty-nine community-based maternity care staff (public health nurses, social workers, psychologists, and administrators) participated. The two-day training program was delivered in two formats: online (September 2021) and face-to-face (May 2022). Across the two days, the program included 2 h and 50 min of didactic lectures and 2 h and 30 min of interactive group discussion. Content covered core TIC principles, trauma-related responses, applications in perinatal care, and strategies to promote sustainable trauma-informed practice. Participants completed the 35-item Attitudes Related to TIC scale (ARTIC-35) at pre-training, post-training, and six-month follow-up. Mixed-effects modeling was used to examine changes in ARTIC-35 scores over time.

Participants were predominantly women (81.4%). The mean age was 42.5 years and most participants were public health nurses (42.4%), psychologists (25.4%), and social workers (23.7%). Mean ARTIC-35 scores increased significantly from pre-training (5.30, standard deviation = 0.55) to post-training (5.70, 0.59; adjusted coefficient β = 0.40, p < .001) and remained significantly higher at six-month follow-up (5.55, 0.66; β = 0.26, p < .001). Effect sizes were medium (Cohen's d = 0.72) immediately post-training and small to moderate (0.47) at six months.

The training program was associated with significant and sustained improvements in staff attitudes toward TIC. Future research should examine whether favorable attitudinal changes contribute to improving TIC practice and preventing child maltreatment.