This scoping review protocol aims to identify and map barriers and facilitators to implementing the Trauma Recovery Center (TRC) model of care, an evidence-based, trauma-informed, multidisciplinary program for underserved survivors of violent crime. Although the TRC has been adopted in 53 U.S.
settings, there is limited synthesized evidence on implementation challenges and enablers to guide scale-up and adaptation across diverse systems. The review will follow Joanna Briggs Institute methods and report findings per PRISMA-ScR guidelines.
Eligible studies are English-language, USA-based, published 2001–2026, and examine implementation-related barriers or facilitators for at least one core TRC element or analogous psychosocial support within comprehensive trauma-informed care. A two-stage screening with Covidence will determine eligibility, with independent assessment by reviewers.
Data will be extracted and mapped to the Consolidated Framework for Implementation Research (CFIR) and synthesized narratively across CFIR's five domains, supplemented by summary tables linking findings to the review objective. Knowledge gaps will be identified.
Ethics approval is not required. Engagement with NATRC experts will aid dissemination through publications and professional meetings.
A structured map of factors shaping the scale-up of Trauma Recovery Centers: framing, scope, and anticipated learnings
It originated in the United States and has been adopted by a growing number of hospitals and outpatient sites across the country.
Services typically include crisis intervention, psychotherapy (individual and group), medication management, case management, and assertive outreach.
Case management may extend to accompaniment to medical appointments or court proceedings, assistance with Victim Compensation Board processes, housing and financial entitlements support, and facilitation of linkages to medical and social services.
The current scoping review protocol explicitly targets this gap by mapping factors that influence the practical deployment of TRCs, with attention to scale-up and adaptation in varied contexts of care for survivors of violent crime.
It explicitly focuses on the implementation landscape, rather than solely on programme outcomes.
It aligns with the Joanna Briggs Institute (JBI) approach to scoping reviews and plans reporting consistent with guidelines applicable to scoping syntheses (PRISMA-ScR).
The stance is to produce a narrative synthesis that describes how contextual determinants relate to TRC performance.
An initial search in PubMed occurred in June 2025, and the final search strategy will be applied to multiple bibliographic databases: PubMed, Embase, PsycINFO, CINAHL, and Scopus.
To be included, studies must examine barriers or facilitators related to implementation of at least one core TRC element or an analogous psychosocial support program within the context of comprehensive, trauma-informed care for survivors of violent crime.
The inclusion is constrained to studies conducted in the USA, published in English, within 2001–2026.
The extraction will inform a narrative synthesis that is organized around the five CFIR domains: Innovation (the TRC model itself), Outer Setting (the broader policy, funding, and community context), Inner Setting (organizational environments where TRCs operate), Individuals (providers and recipients of TRC services), and Implementation Process (strategies and actions supporting TRC deployment).
The output will include summary tables illustrating how findings align with the review objective and will identify gaps in knowledge.
Engagement with subject-matter experts—the National Alliance of Trauma Recovery Centers (NATRC)—is planned to provide feedback and to aid dissemination.
Planned dissemination channels include peer-reviewed publications and conference or professional forums, including NATRC events.
This restriction informs generalizability, especially to non-US settings, and constitutes a notable limitation for international applicability.
The current effort explicitly shifts emphasis toward implementation science questions—barriers and facilitators to scale-up and adaptation—bacing a broader set of contextual determinants rather than outcomes alone.
The approach emphasizes systematic organization of determinants across domains, with explicit attention to how factors may enable or hinder scale-up and sustainability.
It also recognizes that the breadth of contexts (urban versus rural, funding environments, policy landscapes) may influence the relevance and applicability of identified barriers and enablers.
The model aims to mitigate these outcomes by delivering a coordinated package of mental health and supportive services designed to reduce barriers to care for high-need, underserved survivors.
This growth trajectory underscores demand for scalable structures that can maintain fidelity to core principles while adapting to varied care settings.
Core service modalities include crisis response, psychotherapy, pharmacotherapy management, and case management, with a focus on facilitating practical access to benefits, housing, and social services in addition to clinical care.
The wraparound approach is intended to lower practical and systemic barriers—such as navigation challenges, logistical hurdles, and coordination gaps—that can impede survivors’ engagement and continuity of care.
The scoping review is positioned to illuminate how funding mechanisms, policy environments, organizational readiness, and provider and recipient factors interact to influence successful implementation and sustainable operation.
The five CFIR domains provide a comprehensive map to categorize determinants: innovation characteristics, external context, internal organizational context, individuals involved, and the process of implementation.
This framework supports a systematic exploration of contextual determinants that influence TRC performance in national and state-level contexts.
The researchers indicate that summary tables will accompany the narrative, linking identified determinants to the review’s objective of understanding barriers and facilitators to TRC implementation and scale-up.
Engagement with NATRC is anticipated to add practical perspective and help translate findings into dissemination-ready outputs for practitioners and policymakers.
This includes consideration of funding and policy contexts, organizational capacity, workforce readiness, and the alignment of TRC principles with existing care pathways and trauma-informed care standards.
The emphasis on implementation determinants seeks to support more effective planning, resource allocation, and adaptation to local health system contexts.
The explicit articulation of gaps is intended to drive targeted research, multi-site collaborations, and the development of implementation supports to facilitate scale-up.
Findings will therefore be most applicable to the U.S.
setting and to settings with similar health system characteristics.
If such data are sparse, the resulting synthesis may depict limited deployment intelligence, with consequent implications for the robustness of implementation recommendations.
The review design assumes the ability to capture a coherent set of determinants across sites and time, but real-world heterogeneity may present interpretive challenges.
It explicitly states that generalizability beyond the US is limited by design.
The protocol acknowledges potential gaps in the literature and intends to highlight existing knowledge gaps and areas necessitating further research.
The CFIR framework provides a coherent scaffold to classify determinants and to compare determinants across domains and contexts.