Co-Creating Well-Being: Early Effects of Human-Centered Design and Trauma-Informed Care Capacity Building

Overview: Qualitative analysis of interviews with human services personnel explored early effects of a regional foundation’s grant-making initiative. Trauma-informed care and human-centered design trainings and support were offered to increase engagement, involvement, and partnership with families of young children and staff when designing programs that increase community well-being and reduce trauma.Proposal text: Introduction and Literature:
Trauma and toxic stress arising from poverty, violence, and related socioecological disadvantages have deleterious effects on psychosocial development, school-readiness, and well-being of young children (Bauman et al., 2006; Evans & Kim, 2013; Fredrickson, 2019; Shonkoff et al., 2012). Addressing racism, discrimination, and social determinants of health through strategic capacity building and grant-making is one approach to improving outcomes (Baril et al., 2011). Trauma-informed care (TIC), human-centered design (HCD), and diversity, equity, and inclusion (DEI) practices can inspire participatory service redesign to address complex challenges (Connell et al., 2019; Darragh, 2007; Kia-Keating et al., 2017; Ko et al., 2008).

The current study explored early effects of Co-Creating Well-Being (CCWB); a multiphase project led by a regional foundation to increase human services agencies’ capacity in TIC, HCD, and DEI through education and grant-making.

Methods:
Using a stratified sampling frame, researchers contacted 72 of 127 CCWB-participating agencies. Nf34 agency personnel from Nf33 agencies agreed to be interviewed. Virtual in-depth interviews were conducted between November 2020 and July 2021. Qualitative thematic analysis was used to identify categories and themes.

Results:
Over one-third (36.4%) of agencies were CCWB grantees, 45.4% participated in advanced HCD engagement and interpretation, and 18.2% participated in initial training. Major themes included the “opportunity to change” that this unique project provided, the importance of “centering experiences/needs of clients,” “increasing engagement, involvement, and partnership” with both clients and community, and grappling with the “power to effect systemic change (or not).” Many participants agreed they will ultimately achieve better outcomes by incorporating CCWB into their work. One grantee explained,

"What I’m hopeful, most hopeful about is the idea that we would be able to design an
intervention that not only speaks to and meets the needs of our customers or clients in the
specific area of childhood development and so forth. But that is done in a way that’s both
culturally relevant and competent for our clients…You know, we want them to very much
feel as though that this is something that they have helped us to create, whether that be directly
or indirectly."

As a new concept for participants, barriers to HCD engagement emerged: 1) perception that HCD is a time, labor, or financially intensive process; 2) inflexible organizational cultures and funding streams; 3) certain human service organizations (e.g., child welfare, health and human services) have difficulty implementing TIC/HCD, likely related to concerns around safety and trustworthiness; and 4) HCD ideas and processes run counter to prior training and grant management experiences and prompt a sense of unease.

Discussion and Implications:
TIC, HCD, and DEI center the needs and experiences of vulnerable community members, who can be empowered to work with agencies to co-create innovative solutions to intractable health and well-being concerns. Early effects of the CCWB grant-making model may inspire educators, practitioners, and philanthropic organizations to engage in similarly bold capacity-building work. Additionally, to achieve desired outcomes, some conditions facilitating the implementation of CCWB need to be established, including supportive organizational, regulatory, and funding environments, and agency stability.