Trauma-informed care (TIC) is increasingly used to address and prevent adverse childhood experiences. However, research on the implementation process of TIC has lagged, limiting its impact and sustainability. The goal of this two-study project was to provide a summary of staff-and system-level contextual factors relevant to TIC implementation. Method: Study 1 was a secondary data analysis of survey data from 760 staff members from human services, health, and education practice settings familiar with TIC. Independent-samples t tests were used to evaluate differences between lower-and higherimplementing organizations on staff-and system-level TIC implementation drivers. These drivers were then coded using the Consolidated Framework for Implementation Research (CFIR). Study 2 was a content analysis of the empirical literature on TIC. Study 2 produced information on the staff-and system-level facilitators of and barriers to TIC implementation, which were then also coded using the CFIR. Results: Study 1 suggested that the attributes of the individuals implementing TIC and the implementation climate of the organization played the most central roles. Study 2 identified available resources and the strength and quality of the evidence underpinning the intervention as important contextual factors for TIC implementation. Conclusion: This study used a well-established framework, the CFIR, to elucidate key contextual factors related to the successful implementation of TIC, with the goal of informing the efforts of researchers, practitioners, and policymakers. Clinical Impact StatementAttending to the organizational context and the characteristics of staff and of the intervention is critical to increasing the impact and sustainability of TIC.

Interoperability allows telehealth equipment to interact to achieve predictable results. To address the need for telehealth interoperability, the Alberta Research Council has been working with the Alberta Health and Wellness organization in Canada, and others, to create guidelines and a facility for testing telehealth equipment for compliance with technical interoperability standards. The laboratory consists of two rooms (7 m x 7 m) in a new building. The rooms are wired with easy-to-configure copper and fibre networks for telephone, Switch-56, ISDN, ATM, wireless and satellite services. One room specializes in teleconsultation and tele-education, while the other has facilities for teleradiology and telemonitoring. The rooms are interconnected in order to perform interoperability tests between realtime and store-and-forward equipment. The laboratory was piloted in the summer of 1999.

Arts-based interventions can enhance the quality of life of older adults, but community-dwelling older adults may have reduced access to such interventions. The purpose of this study was to examine whether a creative arts program can improve the overall health and well-being of older adults in low-income housing. A university social work department and community agency collaborated in establishing a professionally run theater group of older adults in two low-income housing buildings in an urban area. All residents were encouraged to participate. The study consisted of three twelve-week acting and improvisation courses, focusing on either staged reading of monologues and dialogues, co-writing a script, or staged reading of a complete play. Each class culminated in a public performance for the building. Fourteen participants enrolled, all African American (11 women, 3 men; mean age 66 years; mean ADL = 1.4 (range of 1-2.5)). Attendance on average was 8 classes. Data were collected through pre- and post-test questionnaires, participant observation of class sessions, semi-structured interviews with building managers, and post-session participant reflections. Thematic analysis was performed, and revealed key themes of increased community belonging, increased confidence, and increased daily coping abilities. Additional themes included the gaining of new artistic skills and interest in continuing classes. Barriers to participation included difficulty in recruitment and absence due to ongoing health conditions and caregiving responsibilities. This project has implications for the potential of arts-based programming to increase well-being for underrepresented community-dwelling older adults.

The nature of dementia care provided by social workers across various hospital settings is unexplored. This study utilized the “rigorous and accelerated data reduction” (RADaR) qualitative analysis technique to explore the process of care among social workers for persons with dementia (PWDs) across a Midwestern tertiary care system with two aims: 1) to identify environmental barriers and supports to quality dementia care in two hospital settings (medical and psychiatric emergency departments (ED), and the main inpatient hospital (IP)), and 2) to identify existing strengths and challenges to high quality social work dementia care within these settings. Twelve qualitative interviews were conducted with a purposive, snowball sample of social workers in dementia care in a large, academic health care system in 2016. Results identify environmental barriers in both settings (physical space design, patient-environment interactions, safety, and discharge disposition). Environmental aspects that promote quality care include supportive staff and family in the patient environment in the IP and ED hospital sections while the discharge disposition is more relevant in the IP. While there are some areas of social work involvement (discharge, psycho-social needs, treatment/management issues) that promote quality of care across locales, the pattern of performing roles varied, e.g. there is more focus on discharge planning and less management of competing demands in the IP than in the ED. Also, social workers were more involved in the diagnosis of dementia in the ED than other settings. We offer policy and practice recommendations to improve care for PWDs in academic hospital settings.

Creative arts can promote social contact and possibly reduce isolation. A professionally run theater group comprised of low-income older adults met for 12 weeks to learn basic skills and perform a play. Using a pre-post questionnaire, data were gathered from the treatment group (n=14) who participated in the class and a non-participating comparison group (n=5) to identify potential program effects on measures of social isolation, community belonging, and social exclusion. Participants were African American living in low-income housing in an urban area. The average age of the sample was 65 years, 21% were men, 83% had at least high school degree, 71% reported good to excellent health, and 58% reported at least one ADL. Regression analyses showed that a sense of community belonging was significantly greater for the treatment group than the comparison group at time 2.This was not the case when considering social isolation or social exclusion. When controls were added (age, health, and previous theater experience), the significant difference remained with higher age predicting a sense of community belonging. The greater number of class sessions attended was also associated with a greater sense of community belonging for the treatment group. Through the shared experience of theater, participants can gain a sense of community, but this activity does not seem to be related to social isolation or social exclusion. It could be that theater participation fosters a sense of belonging due to group dynamics but is not a significant enough activity to reduce a sense of isolation or exclusion.