Table 1 Framework Guiding the EQUIP Intervention
Trauma- and Violence-Informed Care | • Based on understanding the effects of interpersonal (e.g., child maltreatment, intimate partner violence) and structural (e.g., poverty, racism) forms of violence as intersecting, with compounding impacts on health; recognizes that people disadvantaged by systemic inequities often experience multiple forms of violence that have ongoing traumatic impacts • Shifts emphasis from client disclosure of violence experiences to care providers creating a safe environment, including for those most traumatized • Creates a safer environment for all, including staff; counters the tendency to locate ‘the problem’ of trauma primarily in the psyche of those experiencing violence by emphasizing social and structural conditions as causes of trauma |
Contextually-Tailored Care | • Based on understanding how the evolving local community and context shape health and health care inequities • Expands on the notion of patient or client-centered care to tailor services and programs explicitly to the populations served and local contexts • Is responsive to the complexity inherent in designing EOHC with both standardized and tailored components to meet the needs of different contexts and populations; counters a ‘one size fits all’ approach in health care |
Cultural Safety | • Based on understanding the impacts of inequitable power relations, racism, discrimination, colonization, and historical and current inequities on health and health care • Shifts attention from ‘cultural differences’ as the source of the problem to the culture of health care as the site for transformation; moves beyond cultural sensitivity to place responsibility on care providers to create culturally safe environments • Foregrounds social justice goals as integral to health care with the aim of shaping health care practices, organizations and policies accordingly |