{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:48:25Z","timestamp":1792129705647,"version":"4.4.0"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health and social care services increasingly recognise the value of involving people with lived experience in service design and delivery. For people who have experienced multiple disadvantage (combinations of homelessness, mental ill health, addiction, involvement with the criminal justice systems or domestic violence\/abuse), participating in professional settings may be challenging and can risk re\u2010traumatisation and greater disillusionment. However, gaining confidence and competency to do this offers opportunities for personal and professional development, contributing to meaningful change. It is necessary that individuals with lived experience can engage safely and effectively in these settings. This study analyses how an organisation of people who have experienced multiple disadvantage, Independent Futures (IF), enabled co\u2010production within services and systems, to understand how people can be best supported and how involvement impacts them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixteen IF members and three IF staff participated in semi\u2010structured interviews. A staff survey, at two time points, investigated how employees from Changing Futures partner organisations perceived their ability to embed co\u2010production within services, with 147 responses. Internal documentation was analysed to illustrate the diversity of co\u2010production work that IF contributed to.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Putting trauma\u2010informed principles into practice facilitated personal growth, improved confidence and some work skills for IF members, who contributed to 65 different workstreams. However, embedding co\u2010production into wider services and systems proved challenging. Staff survey comments highlighted obstacles related to resources, time and hierarchical cultures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lived experience organisations can model trauma\u2010informed practice and influence systems. Embedding trauma\u2010informed principles requires flexibility, openness and willingness that is sustainable only when everyone adopts and commits to these principles. Any evidence of tokenism destroys trust and undermines the endeavour.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Public Contribution Statement<\/jats:title>\n                    <jats:p>This study was co\u2010produced with people with lived experience of multiple disadvantage and staff participants. Two lived experience IF members were involved in: developing the funding bid, designing the research including designing the staff survey, developing interview topic guides, commenting on information sheets and developing interview arrangements to ensure comfort and safety of IF members. Four lived experience IF members and three members of staff contributed to writing the paper, including reviewing key literature, refining the analysis and developing the discussion and conclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70472","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T07:13:20Z","timestamp":1762154000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Trauma\u2010Informed Principles in Practice: A Mixed\u2010Method Study of Co\u2010Producing Systems Change With People Who Have Experienced Multiple Disadvantage"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2627-3843","authenticated-orcid":false,"given":"Tracey","family":"Stone","sequence":"first","affiliation":[{"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"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-7172","authenticated-orcid":false,"given":"Emily","family":"Eyles","sequence":"additional","affiliation":[{"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"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Traub","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Burrowes","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Halsley","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"S.J.M.","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Gillam","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0668-0874","authenticated-orcid":false,"given":"Maria Theresa","family":"Redaniel","sequence":"additional","affiliation":[{"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"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"},{"name":"National Cancer Registry Ireland Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2159-1482","authenticated-orcid":false,"given":"Sabi","family":"Redwood","sequence":"additional","affiliation":[{"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"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Totti","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Smith","sequence":"additional","affiliation":[{"name":"Independent Futures Changing Futures 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":"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"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/geoj.12358"},{"key":"e_1_2_12_3_1","unstructured":"Department for Levelling Up Housing and Communities. Evaluation of the Changing Futures Programme: Baseline Report.2023a."},{"key":"e_1_2_12_4_1","unstructured":"G.Bramley S.Fitzpatrick J.Edwards et al. Hard Edges: Mapping Severe and Multiple Disadvantage in England.2015."},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckab142"},{"key":"e_1_2_12_6_1","unstructured":"Substance Abuse and Mental Health Services Administration. \u201cSAMHSA's Concept of Trauma and Guidance for a Trauma\u2010Informed Approach \u201d HHS Publication No. (SMA) 14\u20104884 (Substance Abuse and Mental Health Services Administration 2014) https:\/\/ncsacw.acf.hhs.gov\/userfiles\/files\/SAMHSA_Trauma.pdf."},{"key":"e_1_2_12_7_1","unstructured":"Office for Health Improvement & Disparities.Guidance: Working Definition of Trauma\u2010Informed Practice.2022."},{"key":"e_1_2_12_8_1","unstructured":"Department for Levelling Up Housing and Communities. Trauma\u2010Informed Approaches to Supporting People Experiencing Multiple Disadvantage: A Rapid Evidence Assessment.2023b."},{"key":"e_1_2_12_9_1","unstructured":"Homeless Connect. \u201cLatest Housing Statistics Show Homelessness Numbers Continuing to Spiral Upwards \u201d accessed May 30 2025."},{"key":"e_1_2_12_10_1","unstructured":"Nacro. \u201cRise in Number of People Coming Out of Prison Homeless \u201d accessed May 30 2025."},{"key":"e_1_2_12_11_1","unstructured":"A. E. C.Speake. \u201c\u2018Like Having a Perpetrator on Your Back\u2019: Violence in the Welfare System \u201d Sheffield Hallam University 2020."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14719037.2015.1111660"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/14719037.2020.1720354"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/padm.12718"},{"key":"e_1_2_12_15_1","volume-title":"The Social Distance Between Us","author":"McGarvey D.","year":"2022"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31959-1"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40900-021-00324-8"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/09520767221122277"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/09520767221140439"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13795"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/09520767251322317"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8551.12010"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/puar.12465"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-020-00558-0"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540962.2019.1592903"},{"key":"e_1_2_12_26_1","unstructured":"CFE Research. The Role of Lived Experience in Creating Systems Change.2020. Evaluation of Fulfilling Lives: Supporting People With Multiple Needs."},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/15248380241286839"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1080\/14719037.2023.2183244"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.70070"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1108\/HCS-12-2021-0048"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0261018317747444"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/01900692.2021.1921941"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1080\/01900692.2021.1903500"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13014"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12864"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/14719037.2019.1601241"},{"key":"e_1_2_12_37_1","unstructured":"R.Bolden B.Isaac C.Pawson E.Griffin andR.Gasper. Golden Key Local Evaluation Review of Phase 4 System Change Case Studies.2021."},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1108\/HCS-12-2021-0039"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-13339-8"},{"key":"e_1_2_12_40_1","article-title":"Guidance on Co\u2010Producing a Research Project","author":"Hickey G.","year":"2021","journal-title":"NIHR INVOLVE"},{"key":"e_1_2_12_41_1","first-page":"144","volume-title":"Handbook of Action Research","author":"Heron J.","year":"2006"},{"key":"e_1_2_12_42_1","volume-title":"Participatory Action Research","author":"Lawson H. A.","year":"2015"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10560-012-0259-z"},{"key":"e_1_2_12_44_1","unstructured":"Co\u2010production Network for Wales. Co\u2010Production & Involvement Audit: A Self\u2010Assessment for Organisations.2019."},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-5-63"},{"key":"e_1_2_12_46_1","unstructured":"Eurofound. Living and Working in Europe2016.https:\/\/www.eurofound.europa.eu\/sites\/default\/files\/page\/field_ef_documents\/uk_questionnaire.pdf."},{"key":"e_1_2_12_47_1","unstructured":"University of Bristol. REDCAP: Research Electronic Data Capture. University of Bristol accessed September 5 2022."},{"key":"e_1_2_12_48_1","volume-title":"On Becoming a Person: A Therapist's View of Psychotherapy","author":"Rogers C. R.","year":"1967"},{"key":"e_1_2_12_49_1","unstructured":"Department for Levelling Up Housing and Communities. Evaluation of the Changing Futures Programme: Second Interim Report. April 2024."},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327965pli1501_01"},{"key":"e_1_2_12_51_1","unstructured":"Making Every Adult Matter. Making Funding Work for People Facing Multiple Disadvantage. Second Report: Roundtable Write Up.2022."},{"key":"e_1_2_12_52_1","unstructured":"R.Moreton J.Welford andC.Milner. Creating Systems Change: Evaluating the Contribution of the Fulfilling Lives programme.2022."}],"container-title":["Health Expectations"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70472","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hex.70472","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hex.70472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:48:26Z","timestamp":1787579306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hex.70472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,2]]},"references-count":51,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/hex.70472"],"URL":"https:\/\/doi.org\/10.1111\/hex.70472","archive":["Portico"],"relation":{},"ISSN":["1369-6513","1369-7625"],"issn-type":[{"value":"1369-6513","type":"print"},{"value":"1369-7625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,2]]},"assertion":[{"value":"2025-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70472"}}