# Improving Traumatic Stress in Black Women Experiencing Homelessness: Evaluation of a Stakeholder Engaged Intervention

> **NIH NIH R01** · RUSH UNIVERSITY MEDICAL CENTER · 2024 · $634,016

## Abstract

PROJECT SUMMARY/ABSTRACT
 Homelessness and associated traumas disproportionately impact Black women. While women experiencing
homelessness (WEH) universally face traumatic stress, Black WEH are disproportionately impacted by trauma,
including racial trauma. Repeated exposure to trauma contributes to the inequitable development of
posttraumatic stress disorder (PTSD), preventable biopsychosocial health adversity, and worsening of existing
health inequities. Our research has shown that Black WEH identify trauma as a priority health issue, yet,
evidence-based standard of trauma care remains largely unrealized in this population. In response to the dearth
of culturally acceptable trauma care models, our team pilot tested Narrative Exposure Therapy (NET)—a brief,
human rights-informed trauma-focused treatment approach for complex PTSD. Our pilot showed strong
feasibility and effects of nurses delivering NET within shelter settings within six sessions. Interviews with Black
WEH, shelter staff, and mental health professionals, however, highlighted a missing element of cultural
resonance to enable trust building and long-term engagement with trauma care. Stakeholders desired a peer to
be included in the research—involving women with lived experience of homelessness, who most culturally and
experientially mirror participants—to complement and support nurse-delivery of NET. In response to
stakeholders, our solution, NurseNET, integrates a woman with lived experience, or “peer”, into the NET delivery
process. In NurseNET, “a Woman of Color”, “a person who’s been through it, who knows what it feels like” and
“is going to communicate differently” is positioned to be “a solution” to trauma. In this randomized controlled trial
(RCT), we will: Aim 1. Determine the effects of NurseNET in reducing PTSD and co-occurring symptoms in
Black WEH, accomplished via an RCT with 210 Black WEH; Aim 2. Demonstrate the effects of NurseNET in
addressing the social determinants of health (SDoH), including healthcare access, social support, racial trauma
impact, and financial self-efficacy (peers); Aim 3. Assess the acceptability, appropriateness, and feasibility
factors that impact implementation of and engagement with NurseNET, via validated surveys and in-depth
qualitative interviews. Cutting across all five NINR research lenses, we will (1) promote heath equity by reducing
and aiming to eliminate individual and structural inequities related to traumatic stress; (2) address and improve
the SDoH, focusing on trauma, particularly racial trauma; (3) foster population and community health, addressing
trauma as a growing public health challenge; (4) encourage prevention and health promotion, engaging Black
WEH in trauma-informed relationships that model optimal care engagement; (5) assess an innovative nurse-led
care model that can be embedded within existing healthcare systems, solving for long-standing clinical and policy
challenges. Our study will advance nursing research towar...

## Key facts

- **NIH application ID:** 10941880
- **Project number:** 1R01NR021261-01
- **Recipient organization:** RUSH UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Kirsten Dickins
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $634,016
- **Award type:** 1
- **Project period:** 2024-07-16 → 2024-10-18

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10941880

## Citation

> US National Institutes of Health, RePORTER application 10941880, Improving Traumatic Stress in Black Women Experiencing Homelessness: Evaluation of a Stakeholder Engaged Intervention (1R01NR021261-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10941880. Licensed CC0.

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