Evaluation of Trauma-Informed Integrated Health Models of Care for Women: A Qualitative Case Study Approach

For victims of partner abuse and trauma in Southwestern Ontario, unique options are available showcasing integrated models of trauma-informed care between social service agencies and primary health-care providers; however, little formal evaluation of these integration models has been completed. The purpose of this multiple case study approach is to examine the acceptability and perceived impacts of two models of trauma-informed social and primary care services, and identify gaps and recommendations for improving the quality of services offered to marginalized women. Participants were recruited from two models of care (facility- and system-level integration) utilizing three groups of participants: (a) administrators (n = 4); (b) frontline service providers (n = 10); and (c) women who utilized the services (n = 25). Despite the different approaches and limited resources, both integration models were acceptable in terms of suitability and comprehensiveness of integration and were impactful through strong partnerships and ameliorated system navigation. Unique to the facility-level integration model (e.g., had a nurse practitioner available onsite) was increased accessibility to health care and perceived improved mental and physical health in spite of the gaps in service provision and desire for additional services. Specific to the system integration model was the highlighted divergent views of care from outside health and social services resulting in an expressed desire by women for a facility integration approach. This study found, regardless of the model, that facility or system integration was highly acceptable and perceived to be impactful for victims of partner abuse and trauma.