{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T08:47:21Z","timestamp":1792140441543,"version":"4.4.0"},"reference-count":58,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000724","name":"Health Foundation","doi-asserted-by":"publisher","award":["Q Exchange 2446641"],"award-info":[{"award-number":["Q Exchange 2446641"]}],"id":[{"id":"10.13039\/501100000724","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Health, social care, charitable and justice sectors are increasingly recognising the need for trauma\u2010informed services that seek to recognise signs of trauma, provide appropriate paths to recovery\u00a0and ensure that services enable people rather than retraumatise. Foundational to the development of trauma\u2010informed services is collaboration with people with lived experience of trauma. Co\u2010production principles may provide a useful framework for this collaboration, due to their emphasis on lived experience, and intent to address power imbalances and promote equity. This article aims to examine trauma\u2010informed and co\u2010production principles to consider the extent to which they overlap and explore how to tailor co\u2010production approaches to support people who have experienced trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Bridging Gaps is a collaboration between women who have experienced complex trauma, a charity that supports them, primary care clinicians and health researchers to improve access to trauma\u2010informed primary care. Using co\u2010production principles, we aimed to ensure that women who have experienced trauma were key decision\u2010makers throughout the project. Through reflective notes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919), observations of meetings (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), interviews with people involved in the project (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099) and reflective group discussions on our experiences, we share learning, successes and failures. Data analysis followed a framework approach, using trauma\u2010informed principles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Co\u2010production processes can require adaptation when working with people who have experienced trauma. We emphasise the need for close partnership working, flexibility\u00a0and transparency around power dynamics, paying particular attention to aspects of power that are less readily visible. Sharing experiences can retrigger trauma. People conducting co\u2010production work need to understand trauma and how this may impact upon an individual's sense of psychological safety. Long\u2010term funding is vital to enable projects to have enough time for the establishment of trust and delivery of tangible results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Co\u2010production principles are highly suitable when developing trauma\u2010informed services. Greater consideration needs to be given as to whether and how people share lived experiences, the need for safe spaces, honesty and humility, difficult dynamics between empowerment and safety\u00a0and whether and when blurring boundaries may be helpful. Our findings have applicability to policy\u2010making, funding and service provision to enable co\u2010production processes to become more trauma\u2010informed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Public Contribution<\/jats:title>\n                    <jats:p>Bridging Gaps was started by a group of women who have experienced complex trauma, including addiction, homelessness, mental health problems, sexual exploitation, domestic and sexual violence\u00a0and poverty, with a general practitioner (GP) who provides healthcare to this population, alongside a support worker from the charity One25, a charity that supports some of the most marginalised women in Bristol to heal and thrive. More GPs and healthcare researchers joined the group and they have been meeting fortnightly for a period of 4 years with the aim of improving access to trauma\u2010informed primary care. The group uses co\u2010production principles to work together, and we aim to ensure that women who have experienced trauma are key decision\u2010makers throughout our work together. This article is a summary of our learning, informed by discussion, observations and interviews with members of the group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.13795","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:40:48Z","timestamp":1689036048000},"page":"1895-1914","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Trauma\u2010informed co\u2010production: Collaborating and combining expertise to improve access to primary care with women with complex needs"],"prefix":"10.1111","volume":"26","author":[{"given":"Helen","family":"McGeown","sequence":"first","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Potter","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Stone","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"},{"name":"The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Swede","sequence":"additional","affiliation":[{"name":"Lived experience experts Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Cramer","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Bridging Gaps Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Horwood","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"},{"name":"The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Carvalho","sequence":"additional","affiliation":[{"name":"One25 Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florrie","family":"Connell","sequence":"additional","affiliation":[{"name":"One25 Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene","family":"Feder","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8773-846X","authenticated-orcid":false,"given":"Michelle","family":"Farr","sequence":"additional","affiliation":[{"name":"Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"},{"name":"The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-020-00558-0"},{"key":"e_1_2_11_3_1","volume-title":"Guidance on Co\u2010producing a Research Project","author":"Hickey G","year":"2018"},{"key":"e_1_2_11_4_1","volume-title":"COVID\u201019 and Co\u2010production in Health and Social Care Research, Policy, and Practice. 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