GeneTIC Workgroup: Genetics Care that Is Trauma-Informed
GeneTIC is interdisciplinary workgroup of behavioral health providers, genetic providers, medical providers and parents/caregivers of patients with genetics conditions, who’s goals is to:
- To increase provider education and training on how to best work with patients and families with genetics conditions who have experienced or who are at-risk for trauma
- Improve understanding of needs and barriers facing patients, families and providers in order to develop and implement trauma-informed protocols and services
Funded by the Midwest Genetic Network (2022-2024; HRSA; UH7MC30775), the geneTIC workgroup lead the “Assessing Provider perspectives, needs and barriers to implementing trauma-informed care in medical clinics serving patients with genetic conditions” study. This mixed methods study aimed to understand the perspectives, needs and barriers to implementing trauma-informed care in medical genetics clinics. Data analysis and dissemination is ongoing.
In January 2025, Dr. Sala-Hamrick was awarded a small research fellowship from Eastern Michigan University for her project “Developing a Trauma-Informed Care Protocol for Pediatric Patients and Families with Genetic Diseases.” The central aim of this project is develop a trauma-informed protocol for screening, brief intervention and referral programs in medical genetics clinics. From April-September 2025, in collaboration with members of the STAR lab, the geneTIC Workgroup, we have developed the a “ALIGN Protocol” — Assess, Lead & Listen, Intervene, Guide to Services, and Navigate & Nurture for implementation in medical settings serving children with genetics conditions. The protocol allows a comprehensive and easy-to-follow guide for patients/families, providers/staff, and organizations to engage in trauma-informed care practices, including patient, caregiver, and staff/provider support, as well as lead timely detection and intervention of posttraumatic stress symptoms in genetic condition populations. Please see here for a more detailed introduction to the protocol. This line of research continues with plans for a pilot study through a partnership with a medical genetics clinic underway.
A third research project Patient, Parent and Caregiver Perspectives in Genetics Care (PPG) is currently underway. This mixed methods study aims to 1) better understand the experiences of genetics patients and their parents/caregivers (including what types of traumatic or stressful experiences patients and families have within the health system, how it impacts their relationships with healthcare providers and systems, and what they feel they need from providers to improve their care), 2) assess patients’ current understanding of trauma-informed care, 3) understand the feasibility and acceptability of trauma-informed approaches and treatments from a patient perspective. This study is expected to inform the final development of the ALIGN protocol before initial pilots.
Future ongoing research conducted by this workgroup will focus on further understanding the needs and experiences of patients and providers and adapting and implementing other trauma-informed and behavioral health programs in complex care settings.
Reaching Our Community Youth (ROCK): Understanding the Impacts of School-based Mental Health Coaching Program
In partnership with the ROCK Center for Youth Development and the Michigan Public Health Institute, the STAR lab is conducting a research study (2025-2026; funded by the Michigan Department of Labor and Economic Opportunity) and evaluation of ROCK’s Discover You, school based programs aimed at supporting positive psychosocial development of youth. Using both qualitative and quantitative methods, the project aims to understand the impact of participation in this paraprofessional delivered, school-based program on youth outcomes and the perspectives and impact of the program on the adults who deliver it. Data collection has been successfully completed with analysis and disseminate ongoing.
Experiences Seeking Healthcare Study
Numerous factors impact an individual’s decision to seek professional psychological or physical healthcare. Potential factors include the number and severity of symptoms, the degree of functional impairment one is experiencing, what and how many coping skills and other supports one has, and the perceived stigma or other influences in one’s life have on seeking support. However, little is known about how potentially traumatic, adverse events or incidents of discrimination or bias are associated with seeking care, particularly in relationship with other factors and among groups of different religious, ethnic, racial and political orientations. One particularly vulnerable population is young adults (age 18-26) who are at significant risk for experiencing both physical and mental health conditions, often do not engage in healthcare and are exposed to many external influences that may impact their experiences seeking care (ex. family views, cultural perspectives and social media influences). This longitudinal study aims to 1) understand the experiences of young adults seeking care, 2) assess other external and internal factors that may impact their experiences and perspectives around healthcare and 3) utilize this information to inform future healthcare quality improvement projects and public health education for young adults.
Integrated Healthcare and Trauma-Informed Approached in Integrated Care Settings
Dr. Sala-Hamrick is currently collaborating with several health systems and advocacy groups to develop projects focused on integrating behavioral health practices and services into healthcare settings, including pediatric primary care, family medicine and complex pediatric care settings (inpatient and outpatient). Stay tuned for updates on this work. Much of this work is focused on developing and implementing brief screening, intervention and referral protocols to increase early identification and access to trauma-informed and trauma-focused services for individuals in need. Moreover, this work includes understanding how to best support providers and staff, refer patients to services that align with their needs and perspectives and increase the likelihood that implemented programs will be implemented effectively and sustained long-term.
Within this work, members of STAR have been conducting A Scoping Review of Trauma-Screening Protocols in Pediatric Primary Care in order to identify the trauma-informed screening protocols that currently exist in pediatric primary care as well as their elements and impact. This review will aid in better understanding the current landscape of pediatric primary care care, and inform future efforts in protocol development, research, evaluation, and implementation in pediatric care settings. The initial review’s OSF preregistration can be found here. A poster regarding the methodology and preliminary considerations has been presented at the Michigan ACE Initiative conference in Lansing, MI in May 2025 (please click here for the full abstract). The initial project’s manuscript is currently in preparation. Additionally, a second project is being conducted, building upon the initial scoping review data, which focuses on implementation, effectiveness, and quality of such protocols. Updates to follow soon.
Trauma Recovery and Access in Chronic Exposures
TRACE (Trauma Recovery and Access in Chronic Exposures) is a program of research focused on understanding how effective trauma treatments are in addressing symptoms associated with chronic trauma exposure. Chronic trauma refers to exposure to multiple, prolonged, and often interpersonal traumatic events—such as childhood abuse, domestic violence, captivity, or war—that occur under conditions of entrapment or helplessness (Cook et al., 2003; Herman, 1992).
Although there is growing recognition of chronic trauma and complex trauma presentations, significant gaps remain in the evidence base regarding how best to treat these experiences. TRACE aims to address these gaps by examining both the effectiveness of existing trauma-focused interventions and the ways in which treatments are adapted in real-world clinical settings.
TRACE is the qualifying exam and dissertation project of Kanica Bhutoria. As part of this work, we have completed a systematic review synthesizing the effectiveness of trauma-focused treatments (established evidence-based interventions, adapted protocols, and emerging approaches) for adults with histories of chronic trauma. We are currently in the planning phase of a mixed-methods study designed to (1) examine how trauma therapists treat chronic trauma, including whether and how they adapt treatment protocols, and (2) center client perspectives to better understand their experiences, needs, and preferences in trauma treatment.
Trauma Training for Implementation Project
The Training for Implementation project (TIP) is an implementation-focused research initiative examining how trauma-informed and culturally responsive care trainings influence clinical practice and provider well-being across healthcare settings. The project centers on understanding providers’ baseline trauma-informed care (TIC) knowledge, values, comfort, and perceived barriers, as well as evaluating whether targeted training supports meaningful learning, retention, and application of TIC principles in everyday clinical encounters.
To evaluate training impact, the TIP project uses survey-based assessments administered before and after training, with follow-ups 6-weeks and 3-months post-training to examine retention and real-world application of skills. These assessments capture changes in TIC and culturally responsive care knowledge, implementation intentions, self-reported practice behaviors, and provider well-being outcomes, including burnout and secondary traumatic stress.
While the current implementation focuses on Advanced Practice Providers (APPs), specifically Physician Assistant (PA) students (current collaboration with Wayne State University’s PA school), the training and evaluation framework are intentionally designed to be adaptable for use with other healthcare provider groups and practice settings. The TIP project aims to inform best practices for trauma-informed training design and support more equitable, responsive, and sustainable care across healthcare systems.
Essentials for Childhood Data to Action: Preventing Adverse Childhood Experiences
The Michigan Essentials for Childhood: Preventing Adverse Childhood Experiences Data to Action project (1 NU81CE002073-01-00; Edick) is a 5-year 2.4 million dollar cooperative agreement awarded to the Michigan Public Health Institute by the Centers for Disease Control, Division of Violence Prevention. The project aims to 1) increase the collection, accessibility and use of youth-based surveillance data to better understand the experiences of children and adolescents in Michigan, 2) implement statewide and local evidence-based ACE prevention programs and 3) conduct ongoing data to action activities to understand how to better prevent and mitigate the impact of ACEs. Dr. Sala-Hamrick is an active collaborator on this project and STAR lab students may have opportunities to become involved in the future. https://www.mahp.org/2023/10/18/mphi-awarded-2-4-million-dollars-to-lead-statewide-efforts-in-preventing-adverse-childhood-experiences/
Fractured Foundations: How Early Sibling Violence Shapes Adult Relationship Quality, Mental Health, and Health-Seeking Behavior
Fractured Foundations is a research study examining how experiences of sibling aggression during childhood are associated with adult mental health, sibling relationship quality, and healthcare utilization in young adulthood. Sibling aggression is a common yet often unrecognized form of family violence, and its long-term effects on wellbeing and help-seeking remain understudied.
Using survey-based methods with college-aged adults, this study explores links between early sibling aggression, symptoms of anxiety, depression, and traumatic stress, and patterns of healthcare and mental healthcare engagement. A key focus of the project is understanding whether current adult sibling relationship quality helps explain associations between early experiences of aggression and adult outcomes. Findings from this project aim to contemplate sibling aggression as an important developmental risk factor and inform trauma-informed approaches to mental health care, as well as interventions that improve access to mental health support among young adults.
STAR Research Collaborative 