How Is Cultural Responsiveness Integrated Into Trauma-Informed Care in Adult Healthcare Settings? A Scoping Review.

ObjectiveTrauma does not occur in a cultural vacuum. Individuals' experiences of trauma and their interactions with the healthcare systems are shaped by identity, socioeconomic conditions, and historical context. Substance Abuse and Mental Health Services Administration recognises these influences through its Trauma-Informed Care (TIC) principle, 'Cultural, Historical, and Gender Issues', which is commonly operationalised through cultural responsiveness. This scoping review mapped how cultural responsiveness has been defined, implemented, and evaluated within trauma-informed adult health care settings.MethodsA scoping review was conducted using the Joanna Briggs Institute (JBI) methodology for scoping reviews. We searched MEDLINE, EMBASE, PsycINFO, and CINAHL for peer-reviewed empirical studies of any study design published since 2001 that reported on TIC interventions incorporating cultural responsiveness. Eligible studies involved adults aged ≥18 years receiving healthcare, individual healthcare providers, and/or organisations delivering adult healthcare services. The concept was cultural responsiveness to operationalise the TIC principle- 'Cultural, Historical, and Gender Issues', and the context was any healthcare setting.ResultsWe screened 6,484 records, and included 11 studies conducted in the USA, Canada, and Australia. Following deductive coding using SAMHSA's TIC framework, studies were inductively categorised by target population and number of implementation domains where cultural responsiveness were implemented, identifying three categories: multi-domain, training-only, and practice-only implementation of cultural responsiveness. Seven of the eleven studies reported equity oriented characteristics mapped to the PRO EDI framework.ConclusionDefinitions, implementation strategies, and evaluation methods varied considerably and were shaped by context. All included studies were conducted in three high-income countries, highlighting a significant gap in evidence from other healthcare contexts.