Addressing trauma and promoting resiliency in pediatric primary care: Learning from early adopters in the California safety net

The dual pandemics of racism and COVID-19 have underscored the urgency of effectively responding to trauma and promoting resiliency in pediatric primary care.  At the same time, research about what works is still in process and best practices have not yet been standardized. Since 2017, CCHE has contributed to learning in the field by evaluating programs that support health care organizations in adopting practices to be more healing-centered, including screening and responding to adverse childhood experiences.  In doing this work, we’ve learned about the importance of meeting teams where they are in their journeys to becoming healing organizations and the opportunities for transformational change within organizational cultures.

We discovered that becoming a healing-centered organization requires complementary efforts. This starts at the top with meaningful support and buy-in from organizational leadership, and continues with commitment across the organization, from front-line staff to clinical care teams to custodial and security staff. It requires shifting the way people conduct their work at every level from the visible clinic environment to the way care is delivered within and beyond the clinic walls.

The evaluation of the Resilient Beginnings Collaborative (RBC) was an opportunity to capture lessons and promising practices from those at the forefront of this work in the San Francisco Bay area. RBC is a partnership between the Center for Care Innovations (CCI) and Genentech Charitable Giving and is part of Genentech’s Resilience Effect initiative. The two-year program launched in June 2018 and supported seven safety net organizations in strengthening their capacity to address childhood adversity and promote resiliency in pediatric care. The foundational work of RBC strengthened the participants’ ability to respond to the traumas of 2020 from the COVID-19 global pandemic and police violence towards Black people to the wildfires that raged through several RBC communities. The experience and lessons of RBC are contributing to a new program funded by Genentech and implemented by CCI called the Resilient Beginnings Network, which is an opportunity to expand and deepen this work.

For more information about what we learned in RBC, read our final evaluation brief.