Rural primary care workforce views on trauma‐informed care for parents experiencing complex trauma: A descriptive study

Background An important service system for rural parents experiencing complex trauma is primary health care. Aim To investigate workforce knowledge, attitudes and practices, and barriers and enablers to trauma-informed care in rural primary health care. Material & Methods This study used a descriptive, cross-sectional design. It involved an on-line survey conducted in 2021 in rural Victoria, Australia. Participants were the primary health care workforce. The main outcome measures were study-developed and included, a 21-item Knowledge, Attitudes and Practices tool, a 16-item Barriers and Enablers to Trauma-Informed Care Implementation tool, and three open-ended questions. Results The 63 respondents were from community health (n = 40, 63%) and child and family services (n = 23, 37%). Many (n = 43, 78%) reported undertaking trauma-informed care training at some point in their career; with 32% (n = 20) during higher education. Respondents self-rated their knowledge, attitudes and practices positively. Perceived enablers were mainly positioned within the service (e.g. workforce motivation and organisational supports) and perceived barriers were largely external structural factors (e.g. availability of universal referral pathways, therapeutic-specific services). Open-ended comments were grouped into four themes: (1) Recognition and understanding; (2) Access factors; (3) Multidisciplinary and collaborative approaches; and (4) Strengths-based and outcome-focused approaches. Discussion & Conclusion Primary health care is an important driver of population health and well-being and critical in rural contexts. Our findings suggest this sector needs a rural trauma-informed care implementation strategy to address structural barriers. This also requires policy and system development. Long-term investment in the rural workforce and primary care service settings is essential to integrate trauma-informed care

Does flexible work 'work' in Australia? A survey of employed mothers' and fathers' work, family and health

Workplace flexibility is perceived to benefit parents yet evidence of the effectiveness of formal work arrangements in promoting parents’ health is mixed, and few have evaluated informal flexibility. This study investigates Australian mothers’ and fathers’ use of formal (employer-provided) and informal (self-directed) work arrangements and associations with work-family conflict and health outcomes (psychological distress, occupational fatigue, burnout). Online survey data from a national cross-sectional sample of 4268 employed parents (one or more children ≤18 years) were collected in 2016. Standardised measures of health outcomes were reported. Analyses were stratified by gender given the gendered division of work and care in Australia. Multivariate linear regression analyses showed greater use of flexible work arrangements (e.g. flexitime, flexiplace) was associated with lower fatigue and less burnout for fathers and mothers. Conversely, higher use of flexible leave arrangements (e.g. purchased leave) and informal arrangements (e.g. performing family-related tasks at work) were each associated with poorer health outcomes. Findings contribute novel evidence on the status of workplace flexibility for Australian fathers and mothers. Flexible work arrangements may have some health benefits, yet the widespread use of informal arrangements suggests flexible workplace provisions alone are not meeting parents’ needs for family-related support

Interventions during pregnancy or up to two years after birth for parents who are experiencing complex trauma or have experienced maltreatment in their childhood (or both) to improve parenting capacity or socio-emotional well-being

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of interventions provided to support parents experiencing complex trauma or who have experienced childhood maltreatment (or both) on parenting capacity and parental psychological or socio‐emotional well‐being