Defense Date


Graduation Date

Summer 8-13-2022


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

Alison M. Colbert

Committee Member

L. Kathleen Sekula

Committee Member

Betty Bekemeier


trauma informed care, STD clinics, sexual risk behaviors, sexually transmitted diseases, violence


Introduction: Sexually transmitted diseases (STDs) are increasing in the United States and often result in long-term adverse health outcomes. New York State (NYS) local health departments (LHDs) provide public STD clinics for high risk populations also found to have high rates of violence. This study examined if/how trauma informed care (TIC) is implemented in these settings. The study sample were LHD STD Program Directors in NYS.

Method: A convergent parallel mixed methods study design was used which included an online survey and follow up interviews. Survey data were analyzed using univariate statistics and conventional content analysis was used to analyze interview data.

Results: Surveys (n = 11) and interviews (n = 10) diverged in how participants described if/how TIC is practiced in these settings. Participants reported TIC education and training and the capacity to integrate TIC into STD clinics on surveys, but these data were not confirmed during interviews. Interviews revealed three themes: 1) Trauma is prevalent among individuals attending STD clinics, 2) TIC is understood as screening, responding to emergencies, and referrals to address trauma, and 3) STD clinic governance and infrastructure are challenges to integration of TIC in these settings. Participants also described significant negative impacts on STD clinics due to LHD resources diverted to ongoing LHD COVID 19 pandemic response efforts.

Conclusions: TIC is not routinely practiced in these settings. Participants need a broader understanding of how to integrate TIC into direct STD clinic services. More research is needed to identify best practices for trauma screening and providing education and training to implement TIC in these settings. More resources are also needed for STD clinics as LHDs continue to respond to the ongoing pandemic.



Additional Citations

Brewer, A., Colbert, A. M., Sekula, K., & Bekemeier, B. (2020). A need for trauma informed care in sexually transmitted disease clinics. Public Health Nursing.