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.
Introduction The Trauma Recovery Center (TRC) is an evidence-based model of care designed to meet the needs of underserved survivors of violent crime through the provision of comprehensive mental health and psychosocial services. Originally developed in the USA, the TRC model has been adopted by 53 hospitals and outpatient settings nationwide. Its demonstrated effectiveness supports its potential for international scale-up, particularly in countries seeking to improve their responses to interpersonal violence and trauma. While the core principles of the model remain universally consistent, there is a striking paucity of synthesised evidence on implementation barriers and enablers, necessary to guide effective scale-up and adaptation across diverse systems of care. The objective of this scoping review is to identify and map barriers and facilitators that influence implementation of the TRC model of care.
Methods and analysis The scoping review was initiated in May 2025 and is expected to be completed in May 2026. The review will be conducted following the Joanna Briggs Institute methodology for scoping reviews. Results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. The initial PubMed search was conducted in June 2025. The finalised search strategy will subsequently be applied to PubMed, Embase, PsycINFO, CINAHL and Scopus databases. A two-stage screening process using Covidence software will be used to determine study eligibility. To be included, studies will be required to have examined implementation-related barriers or facilitators associated with at least one core element of the TRC model or analogous psychosocial support programmes within the context of comprehensive, trauma-informed care for survivors of violent crime. Studies conducted within the USA and published in English between 2001 and 2026 will be included.
All studies will be independently assessed for eligibility. Data will be extracted and mapped using the Consolidated Framework for Implementation Research (CFIR). Extracted data will be analysed and synthesised narratively across the five CFIR domains, accompanied by summary tables that describe how the findings relate to the review objective. Existing knowledge gaps will be identified and discussed.
Ethics and dissemination Ethics approval is not required for this scoping review. Experts from the National Alliance of Trauma Recovery Centers (NATRC) will be engaged to provide feedback on the study findings and support the dissemination of results. Dissemination activities will include peer-reviewed publications and presentations at academic conferences and professional events, such as NATRC’s technical assistance and learning community training sessions.
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The review follows the Joanna Briggs Institute methodology and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines to ensure methodological rigour and reproducibility.
Covidence review management software will be used to ensure consistency and transparency in the study selection process.
Only studies that examined the Trauma Recovery Center model within the USA will be included, thus limiting generalisability to non-US settings.
Only English-language publications will be included, given the focus on studies conducted in the USA.
Violent criminal victimisation is a significant public health issue in the USA. According to the most recent reports by the Alliance for Safety and Justice, one in three Americans (34%) has been a victim of violent crime, with more than two out of three victims repeatedly victimised in the past decade. 1 Marginalised and vulnerable individuals, groups and communities are disproportionately impacted by violence, resulting in adverse health and socioeconomic outcomes. Many survivors experience significant adverse mental health outcomes, including acute stress disorder, post-traumatic stress disorder (PTSD), depression, complicated grief, anxiety, substance abuse disorders, as well as disability, chronic illness and financial hardship. 2 People who were victims of violence in the past 10 years were 3.8 times more likely to have experienced PTSD, 3.6 times more likely to have declared bankruptcy and twice as likely to experience a life-threatening illness. 1 Despite representing high-risk, high-need populations, these groups are frequently excluded from traditional healthcare-based violence intervention programmes. 3 4
To address this service gap, the University of California, San Francisco, established the Trauma Recovery Center (TRC) model of care in 2001. 3 The model was designed to provide and evaluate comprehensive mental and psychosocial services for victims, and to better understand the treatment and psychosocial needs of low-income, injured victims of crime who have not been served by the mental health system. 5 The TRC model is distinguished by its interdisciplinary, team-based approach. It integrates professionals from medicine, mental and behavioural health, social work and public health across hospital and outpatient settings. 6
The TRC model aims to promote equitable access to care through comprehensive wraparound services that support healing and stability for survivors of violent crime and their loved ones. 3 Mental health and support services include, but are not limited to, crisis intervention, individual and group psychotherapy, medication management, case management and assertive outreach. Case management services may involve accompanying clients to medical appointments or court proceedings; assisting with the completion and submission of applications to the Victim Compensation Board; facilitating access to safe housing and financial entitlements; and providing linkages to medical and social services. 3
The TRC model is not intended to replace traditional mental and behavioural health services; rather, by combining assertive outreach, trauma-informed care and assistance with everyday needs, TRCs are disrupting the cycle of violence and removing barriers to care for survivors of violent crime who might otherwise not have access to care. 5 7–9
Prior to 2017, the TRC model was implemented at only five sites in California. 9 Over the past 8 years, it has expanded significantly, with 53 TRCs currently operating across the USA. 7 Given the observed and anticipated scaling of the TRC model, there is a clear demand within the community of practice for comprehensive, well-structured information on the factors that facilitate or hinder the successful performance of newly established TRCs, to better inform scale-up and decision-making in providing critical services to survivors of violent crime.
A preliminary search of the PubMed, MEDLINE, Web of Science and Scopus databases identified only one scoping review on the TRC model of care. 9 The review primarily focused on programme outcomes, such as mental health improvements, victim compensation and treatment engagement at only three TRC sites, which limits the generalisation of the findings. Despite these constraints, the review offers important preliminary insights into the TRC model’s potential, while underscoring the need for more rigorous research designs and broader multisite collaboration. The proposed review marks a significant departure by centring on the critical question of how TRCs can be effectively scaled and adapted, with particular emphasis on the factors that facilitate or impede their real-world implementation. Thus, this review expands the conversation beyond isolated programme outcomes by examining such structural factors as funding, policy contexts and rural/urban health system readiness. This broader perspective fills an urgent knowledge gap in understanding how to sustain TRC services for a variety of crime survivors, and thus, builds a more comprehensive evidence base to guide TRC replication and scale-up nationwide.
Furthermore, the proposed scoping review will apply an implementation-science lens by using the Consolidated Framework for Implementation Research (CFIR) 10 to systematically identify contextual determinants (ie, barriers and facilitators) that influence TRC performance across multiple settings. CFIR offers a comprehensive set of constructs organised across five domains: (1) Innovation domain—the TRC Model itself; (2) Outer setting domain—the broader national, state and community context of implementation; (3) Inner setting domain—the specific organisational context where TRCs operate; (4) Individuals domain—providers and recipients of TRC services and (5) Implementation process domain—strategies and actions supporting TRC implementation. This framework will provide a structured approach to exploring how contextual factors influence the implementation of the TRC model, ensuring that various contextual barriers and facilitators are considered.
The objective of this scoping review is to systematically identify barriers and facilitators that affect the implementation of the TRC model in providing critical services to survivors of violent crime. This review seeks to answer the following research question: What is known from the literature about the contextual factors working for and against TRC model implementation efforts in national and state-level contexts?