A case study methodology was used to understand the phenomenon of translating sport-based trauma-sensitive practices to a community context (Creswell & Poth, 2018). This case study is bounded to the BBL program, developed by the leadership team, and hosted in 18 BGC Canada clubs, involving 80 + club staff and 600 + members. The KTAC guided project development and followed five stages: (a) planning—problem-identification and conceptualizing BBL to align with BGC Canada’s needs; (b) the pilot—BBL rollout across three core clubs; (c) adaptation—using pilot insights to adapt BBL; (d) expansion—BBL rollout across 10 additional clubs; and (e) sustainability—capacity-building and knowledge dissemination activities to improve BBL and trauma-sensitive practices in BGC Canada (see Fig. 1 for the interactions between BBL stages and KTAC phases).
In the planning stage, the KTAC phase of identifying a problem, determining the know-do gap, and identifying, reviewing, and selecting knowledge, were focused on. The leadership team identified the problem that many BGC Canada club members (hereafter referred to as ‘members’) face risk of traumatic exposure (e.g., > 70% of the families served are in low-income situations). These members may lack access to health promotional supports, especially if they have not been screened with a trauma-related disorder, despite exhibiting trauma-related symptoms. As well, many members may not have the developmental capacities to understand or articulate their experiences of trauma—or lack power to disclose when the sources of trauma are from their close relationships. Thus, the leadership team identified the need to equip BGC Canada staff to support members’ unique needs. Many staff were already equipped with training related to facilitating positive youth development (e.g., HIGH FIVE®), mental health first-aid, crisis intervention, and referral protocols when identifying children who needed external health supports or clinical care. As well, many staff possessed experience in facilitating several youth developments programs across domains of leadership, education, creative arts, and recreation. However, many staff were not equipped with knowledge (know) or skills (do) to support trauma-exposed members in times of dysregulation, promote self-regulation practices, or design environments that minimize harm and foster resilience-building.
To address this know-do gap, the knowledge that was identified, reviewed, and selected was sport-based trauma-sensitive practices and the purpose of this project was to build BGC Canada staff’s application of these practices. These practices were chosen given the popularity of BGC Canada’s sport programs, the numerous benefits these practices offer (Massey & Williams, 2020), and the ease to which these practices can be embedded into staff’s existing work. Trauma-sensitive practices also operate at a low-profile—programs do not need to be marketed as trauma-related to members or caregivers; rather, programs can be branded as unique sport experiences that intentionally teach resilience-related life skills through sport. This strategy avoids stigmatization, allowing all members to participate, undifferentiated by their trauma.
Next, adapt knowledge to the local context was focused on in the BBL planning stage. This process involved adapting sport-based trauma-sensitive practices to the BGC Canada context, within their existing human resources, physical spaces, and organizational capacities. The leadership team met over three days to discuss adaptation and development. The core objectives of these meetings were to: (a) provide psychoeducation to stakeholders on sport-based trauma-sensitive practice, (b) conceptualize a program that can be adapted to BGC Canada clubs, (c) generate buy-in from key BGC Canada managers who may champion the approaches, (d) develop a plan and establish timelines for the project, (e) formulate an evaluation process and identify key outcomes, and (f) solidify a process for collaboration and communication as a leadership team.
From these meetings, the leadership team developed connections with each other, generated value and excitement for the project, and collaboratively established the project goals, which included: (a) develop a training program that will build staff’s competencies to apply sport-based trauma-sensitive practices at their clubs, (b) have staff implement these practices as the BBL program across 13 clubs (reaching 20–25 members [9–12 years old]/club, per season [3 seasons a year]), (c) use a train-the-trainer model to build BGC Canada’s capacity to maintain and sustain BBL, and (d) evaluate program components to inform BBL adaptations. In line with each goal were the intended outcomes: (a) staff implement BBL effectively at their clubs; (b) BBL members experience improvements in basic psychological needs support, resilience-related life skills, and well-being; (c) a master trainer team is formed to train future BBL staff beyond grant duration; and (d) program materials are developed with guidelines for effective BBL implementation.
The leadership team established to communicate regularly on BBL program development over monthly phone/video calls. Roles of team members were also established. Here, BGC Canada administrators were responsible for coordinating, communicating, and checking-in with clubs on an ongoing basis, which included relaying expectations and arranging for staff involvement in BBL trainings. The consultants were responsible for designing and delivering the sport-based trauma-sensitive practice training to staff and holding ongoing phone/video calls with lead staff at each club to answer design questions and offer feedback. BGC Canada managers were responsible for participating in trainings and managing their own club’s design and delivery of BBL.
The researchers were responsible for developing evaluation tools, training staff on how to use the tools, assisting clubs with collecting data during on-site visits, analyzing and communicating these data, and soliciting staff feedback regarding the feasibility of evaluation activities in practice. The program was to be carried out over 4 subsequent years, including 2 years of piloting across three clubs with ongoing adaptation. Evaluation findings from pilot and adaptation stages would inform the expansion to 10 clubs in the final 2 years. Use of a train-the-trainer model would help build and maintain project sustainability beyond grant duration.
The pilot stage involved implementing the BBL training with three BGC Canada clubs, who then went on to design and deliver their first seasons of BBL—with the leadership team’s close monitoring, evaluation, and ongoing support, as per their established roles in the planning stage. In alignment with the KTAC phase assess barriers and facilitators to knowledge use, this BBL stage focused on exploring the successes and challenges that arose in the pilot. Given that multiple KTAC phases can be an undergone concurrently, three sub-phases were also carried out: select, tailor, and implement an intervention, monitor knowledge use, and evaluate outcomes. A multi-faceted, sport-based, trauma-sensitive practice training intervention was designed for staff to learn how to develop BBL programs at their home clubs. Twelve staff participants (three managers, three supervisors, six coaches) across three clubs, were gathered to attend an initial 3-day intensive workshop.
The workshop was primarily facilitated by the consultants, with the support and participation of the researchers and BGC Canada administrators. The topics broadly covered: (a) psychoeducation of the prevalence and impact of trauma on the child, (b) factors that contribute to trauma healing in sport, (c) strategies to intervene with members in times of dysregulation, (d) strategies for coaching and re-designing sport to facilitate resilience-building, (e) strategies to facilitate members’ skill development. The topics were further adapted in subsequent iterations of the training workshop during the BBL’s adaptation stage (see Table 1 for list of workshop modules). The facilitators used delivery strategies such as brief lectures, story sharing, paired and group discussions, active games and sports, coaching practice, role play activities, and workbook activities. Staff received a guidebook as a resource to use post-workshop as they returned to their home clubs to implement BBL. Staff gathered again at 4- and 12-months into programming to attend refresher workshops (2-days each). An online social learning space was established via Slack, where the leadership team and participating clubs shared experiences, resources, strategies, media, and questions with one another throughout the project, in effort to ease access to communications, resources, and learning opportunities.
During program implementation, each club aimed to recruit 20–25 members (ages 9 to 12) per season. The goal was for each club to run three seasons a year, with each season building on the relationships and skill development of the previous season. Members were welcome to participate in multiple seasons. Clubs could choose season length (6–10 weeks), the sport (e.g., basketball, soccer, ball hockey), and session frequency (all clubs chose 1/week). All clubs were responsible for structuring sessions around a universal BBL workout structure, comprised of seven intentional components (see Table 2 for complete details): (a) arrival, (b) warm-up, (c) skill play, (d) transition time, (e) cool down, (f) team time, and (g) departure. This structure offered a predictable schedule of activities, in which members could experience safety, skill-building opportunities, and practice regulating themselves in competitive, real stakes environments (Bergholz et al., 2016).
Staff were trained on several techniques to proactively facilitate members’ regulation (e.g., practicing deep breathing to help calm emotions, allowing unlimited timeouts to rest when feeling overwhelmed, and structuring a space [The Zone] to enter, self-regulate, and return to main activities when ready). Staff also adopted a 4-step framework to connect with members in times of dysregulation: (a) stabilize—support member in a triggered state to re-regulate and arrive to a place where they can have a conversation, (b) explore—facilitate a judgment-free inquiry about what the member is experiencing, (c) plan—co-construct strategies to resolve what happened and to regulate better in the future, and (d) return—co-construct strategies to transition back to the activities on the member’s own will.
The program also focused on teaching three BBL skills tied to resilience-building (see Table 2): (a) come to play (e.g., preparation, self-awareness), (b) build my team (e.g., empathy, seeking support), and (c) play on (e.g., effort, recovery). Strategies to facilitate these BBL skills included defining skills out loud, having a ‘skill of the week’, posters with skills and definitions, encouraging and praising skill use, and reflecting on skills during team time (Bean et al., 2018). These skills were constructed based on evidence of what works in trauma-sensitive sport programming (Edgework Consulting, 2020), understandings of life skill development through sport (Holt et al., 2020), and BGC Canada core values (BGC Canada, 2020). See Supplement 1 for strategies on facilitating BBL skills within the BBL Workout Structure.
In evaluating the program, three questions were proposed: (a) how did staff perceive their training experiences and what value was generated from these experiences? (b) what were the successes and challenges that staff met in implementing their training into practice? and (c) what was the impact of programs on members? A mixed-methods approach was used to address these questions. To explore staff’s training experiences, knowledge surveys and interviews were conducted pre- and post-training, and field notes, pictures, and audio-recordings were taken during training. To monitor successes and challenges, staff completed structured logbooks after each BBL session, participated in multiple focus groups and interviews, and shared conversations on Slack. To examine program impact, members completed surveys on well-being (Tennant et al., 2007), resilience-related skills (Windle et al., 2011), and basic needs support (Bean, Rocchi, et al., 2020; Bean, Sewell, et al., 2020). Members also took part in interviews and arts-based activities, and staff completed report cards of members’ participation (Shaikh et al. 2020a, 2020b).
Evaluation results related to staff’s training experiences revealed that many desired outcomes were reached, including high satisfaction and usefulness of the training workshop for staff, building staff’s BBL-related knowledge and skills, and staff’s use of trauma-sensitive practices in the BBL and into their everyday lives (Shaikh et al., 2018; Shaikh, Bergholz, et al., 2019b). Several facilitators to knowledge use were identified: (a) staff’s existing experiences with trauma-exposed members in BGC Canada helped ease adoption of sport-based trauma-sensitive practice, (b) staff found the training workshops highly engaging, useful, applicable, and valuable; (c) staff perceived that training content aligned with what they experienced in practice, (d) ongoing meetings with consultants facilitated continuous learning for staff, and (e) the pilot allowed room for trial and error, which eased staff’s apprehensions in applying a novel program and practice (Shaikh et al., 2018; Shaikh, Bergholz, et al., 2019b; Shaikh, Forneris, et al., 2019c).
Despite these facilitators, clubs reported several challenges (i.e., Shaikh, Bergholz, et al., 2019b) that were consistent with research in community programs (Forneris et al., 2013; Larson et al., 2015). A major difficulty was in recruiting and retaining children (e.g., scheduling difficulties, building value for the BBL, competition with other programs, referral-recruitment versus open-to-all recruitment. Inconsistent attendance made it difficult for staff to maintain an engaging experience where members can foster positive peer connections. Staff also found it challenging to balance the demands of a structured program with the myriad of children’s behavioral issues (e.g., outbursts, disengagement, aggression), given that BGC Canada staff—and members—are most familiar with unstructured, free play opportunities. As well, clubs encountered staff turnover—an inevitable reality of youth-serving organizations where many staff are part-time or in transition phases of their careers—which led to loss of capacity, especially when staff were BBL trained.
Consistent relationships are primary protective factor in supporting trauma healing (NCTSN, 2015). A benefit of having BBL managers and supervisors attend training was their capacity to step in when staff were absent. This strategy worked well given that the BBL members were also BGC Canada members who attended other programs within the club. Thus, members interacted with supervisors and managers on a regular basis beyond BBL—contributing to consistency in mentorship. Evaluation results related to program impact revealed improvements in outcomes, albeit non-significant; here, perceived well-being trended upward from pre-post season, and members who attended > 80% sessions reported higher basic psychological needs support (Shaikh & Forneris, 2020). Qualitative data analysis revealed that the members reported feeling accepted, having improved friendships, and developing sport and life skills (Shaikh & Forneris, 2020). These positive learning experiences suggested some initial effectiveness of the BBL. Overall, these evaluation findings informed BBL adaptations in the next stage.
Concurrently with the pilot stage, the adaptation stage was informed by the combination of ongoing leadership team meetings, consultations and check-ins with each club, and evaluation results. The KTAC phase of adapt knowledge to the local context was re-visited, using insights of barriers and facilitators to knowledge use to inform ongoing BBL project development; adapting BBL processes at the organizational-level and club-level. These adaptations were communicated through email, bi-monthly meetings, Slack, and refresher training workshops. The major adaptations included: (a) tailoring the training intervention, (b) supporting staff’s motivations and accounting for staff turnover, (c) enhancing recruitment strategies, and (d) transition of training responsibilities to master trainers.
Tailoring the Training Intervention
The leadership team worked together to develop 12 BGC Canada-adapted modules, covering how to build staff’s awareness and value for sport-based trauma-sensitive practice, and how to structure and design a BBL program (see Table 1). These modules were the foundational structure for the training workshop and the development of BBL resources (i.e., the coach guidebook, operating manual, training manual). To address the challenges that staff encountered in intervening with dysregulated members, more focus was added to strategies for managing groups and helping members return to a stabilized state.
Supporting Staff’s Motivations and Accounting for Staff Turnover
At the organizational level, the leadership team established bi-monthly check-ins with all pilot clubs together. This strategy offered additional mentorship and oversight to the staff, building morale, shared understanding, and value for BBL (Ika & Donnelly, 2017), and enabled staff to share experiences and learn from each other. At the club level, managers were encouraged to: (a) choose trainee candidates that were full-time staff and planned to invest in the club long-term; (b) supervise at least half of staff’s BBL sessions and provide them feedback to help monitor, support, and enhance the quality of their BBLs; and (c) have other staff sit in on BBL sessions to observe, participate, learn, and eventually transition into BBL when faced with staff turnover.
Enhancing Recruitment Strategies
At the organizational level, customizable promotional materials were created (i.e., posters, infographics) with BBL branding for clubs to use in their marketing. To enhance recruitment, all clubs were encouraged to remove limits to BBL membership and invite all children to participate regardless of pre-identified risk status. This strategy helped maximize reach and inclusiveness to unscreened trauma-exposed children.
Transitioning of Training Responsibilities to Master Trainers
To promote the self-sustaining capacity of the BBL, a train-the-trainer model was used to train BGC Canada managers and other key staff to become BBL master trainers (Shaikh, Bean, et al., 2019a). To carry this out, an intensive training workshop was facilitated by the leadership team, in which BGC Canada managers learned and delivered the 12 BGC Canada-adapted BBL training modules to their peers and received feedback to improve their delivery. Following the workshop, these newly trained master trainers returned to their home clubs to plan the delivery of BBL training workshops to their staff. These workshops were also observed by leadership team members, who provided feedback. The master trainers were then expected to be help train newly onboarded staff in the expanded rollout.
The expansion involved rolling out, monitoring, and evaluating the adapted training intervention and BBL programs in ten additional clubs across Canada. Three KTAC phases of select, tailor, and implementing interventions, monitor knowledge use, and evaluate outcomes were undergone (again). Here, the master trainers carried out the training intervention as an intensive, in-person workshop to 20 staff, covering the 12 BGC Canada-adapted training modules. The leadership team supported master trainers in communicating expectations, coordinating travel and logistics for clubs, and modifying evaluation tools. The newly trained staff went on to deliver programs at their home clubs, while continuing to receive support from master trainers (e.g., bi-monthly calls), and the leadership team (e.g., via Slack, email, and on-site visits). The same evaluation questions were used to monitor BBL training and program implementation, using a slightly modified mixed-methods approach. For instance, items on knowledge assessments and logbooks were matched to the adapted training modules, and the length and wording of member’s surveys were simplified.
Each club ran one season (~ 6–10 weeks); the second season was cut short due to the COVID-19 pandemic. Currently, evaluation is still ongoing, as clubs offer either in-person, physically distanced program delivery, or virtual delivery. However, initial outcomes of the BBL expansion have indicated that: (a) the training intervention was successful in improving knowledge and attitudes of participating staff in sport-based trauma-sensitive practice; (b) the training intervention was perceived as enjoyable and useful for staff; (c) in most clubs, recruitment of members successfully reached 20–25 + members; however, at least two clubs were well under this mark; (d) having trained staff is essential for running high-quality BBL programs; yet, with staff turnover, clubs without trained staff resorted to traditional practices of youth engagement in sport, resulting in loss of trauma-sensitive practice. Thus, there is a need for incorporating alternative sustainability practices within BGC Canada to maintain BBL quality during and beyond grant duration.
The sustainability stage involves initiatives put in place to continue BBL beyond grant- end, in alignment with the sustain outcomes phase of KTAC. The first goal in this plan was to maintain and expand the BBL (as a sport-based trauma-sensitive practice program) to more clubs across Canada. A second, broader goal was to build staff’s capacities in trauma-sensitive practices across BGC Canada clubs and programs, beyond sport. This second goal was constructed based on advocacy from BBL staff of the value of trauma-sensitive practices and their applicability in club work outside the BBL, as well as interest from additional clubhouses in building their club’s trauma-sensitive capacity. Several processes will contribute to reaching these two goals: (a) using a train-the-trainer model, (b) developing context-specific resources, (c) expanding to reach Canadian newcomers, (d) transitioning to a virtual platform in COVID-19.
Using a Train-the-Trainer Model
Using a train-the-trainer model helped build the organization’s ownership of the program, promoting internal sustainability (Shaikh, Bean, et al., 2019a; Whitley et al., 2015). Here, BBL managers who delivered BBL in the pilot were offered training to develop into master trainers and went on to facilitate BBL training for staff within and beyond their clubs. Clubs with access to master trainers were then able to host sport-based trauma-sensitive practice as a core part of their club’s training. Master trainers also train staff at a national level, whether through facilitating training workshops or consultations with newly onboarded BBL clubs.
Developing Context-Specific Resources
Developing context-specific knowledge products was important for communicating knowledge in clear and user-friendly ways, which can facilitate continued use of knowledge in practice (Holt et al., 2018). Materials were created that can be shared and used universally across the clubs, including the coach guidebook, training manual, promotional materials, and evaluation activities. As well, evaluation findings were shared throughout the project through user-friendly media (i.e., presentations, reports, infographics, and posters). Blogging was used as an effective means of disseminating knowledge beyond academic audiences (Stoneham & Kite, 2017); here, the leadership team published a blog on strategies for integrating trauma-sensitive practices into play (Shaikh et al. 2020a, 2020b. The authors also shared their experiences on integrating evaluation activities within community organizations along with effectives strategies for sport stakeholders to build evaluation capacity (Shaikh et al. 2020a, 2020b).
Expansion to Reach Canadian Newcomers
Given the importance of funding in maintaining relationships and capacity building (Coppola & McHugh, 2018), various means of extending BBL funding have been explored. BGC Canada secured funding to extend BBL across five additional clubs to target Canadian newcomer populations. Direct support for newcomers is needed as they may face unique traumatic exposure; refugees from conflict regions can face loss, grief, family separation, mental health disorders, and migratory stressors (Ley & Mario, 2019). In this expansion, an advisory group was created with BBL managers to share and co-construct strategies for meeting newcomer needs and integrating equity, diversity, and inclusion principles in BBL design, recruitment, and practice. Development of BBL for newcomers is currently underway. This extension has taken on a unique look post-pandemic, where clubs have had to shift their BBL programs to virtual and physically distanced settings.
Transitioning to a Virtual Platform in COVID-19
To effectively meet BBL staff’s needs in the pandemic, staff perspectives were sought through virtual meetings and a needs assessment survey. Staff largely requested more training in trauma-sensitive practices, support to shift BBL virtually, and strategies to facilitate small group, in-person activities. Thus, the leadership team delivered virtual training for staff during Summer 2020, which covered refreshers of BBL content and strategies to facilitate virtual BBL. All clubs then transitioned to a modified BBL in Fall 2020 (i.e., physically-distanced in-person or virtually). Monitoring and evaluation are currently ongoing, to gain insights of successes and challenges of facilitating BBL in a COVID world.
The abrupt shift, the need for trauma-sensitive practices across clubs in Canada, and the success in adapting the BBL based on changing conditions, made it ideal for the leadership team to pursue further options for project scale-out (Ika & Donnelly, 2017). Thus, funding was secured to develop virtual trauma-sensitive training for scale-out to BGC Canada’s 775 clubs nationally. Here, the KTAC will be re-cycled as a second iteration. The problem identified was the need for integrating trauma-sensitive practices across all BGC Canada clubs; the selected knowledge was the BGC Canada-adapted trauma-sensitive practice modules and program materials; this knowledge will be adapted from in-person to virtual via BGC Canada’s virtual e-learning platform; and this training will be implemented to ten BGC Canada clubs, reaching ~ 150 staff.