TIA/CHANGE: E2i Toolkit

Trauma-Informed Approach & Coordinated HIV Assistance and Navigation for Growth and Empowerment (TIA/CHANGE) is an evidence-informed and resilience-focused intervention that provides guidance and structure for becoming a trauma-informed HIV service organization. In collaboration with HIV experts, trauma-informed care experts, and community members, E2i adapted TIA/CHANGE for the Ryan White HIV/AIDS Program (RWHAP) and produced a toolkit that provides the resources needed to implement TIA/CHANGE within RWHAP settings and other HIV care organizations.


To improve client engagement in HIV care by guiding an organization to implement a trauma-informed approach to the delivery of care

Priority Population

People with HIV who have a history of trauma 

Core Elements

1. Organization-level Implementation

  • The intervention affects all aspects of the organization; all key stakeholders are involved
  • All staff develop competencies in trauma-informed care
  • The service environment provides a safe place for healing and wellness
  • People with HIV who have experienced trauma, as well as their family members, are meaningfully involved in all aspects of the implementation of TIA/CHANGE

2. Trauma-informed Approach

  • A trauma-informed organization is one that:
    • Realizes the widespread impact of trauma and understands potential paths for recovery
    • Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the organization
    • Responds by fully integrating knowledge about trauma into policies, procedures, and practices
    • Seeks to actively resist re-traumatization

3. Guiding Principles

  • Organizations should adopt guiding principles that establish a solid foundation for all planning, implementation, and evaluation activities. 
  • Guiding principles align with your organization’s mission, while supporting a trauma-informed approach.


TIA/CHANGE is an ongoing and dynamic endeavor based on three implementation phases (early, mid, and late implementation)


Any organization that offers services to people with HIV

Toolkit Components

This Guide includes:

  • How to plan and implement the intervention
  • Lessons learned during implementation in RWHAP settings
  • Outcomes from the E2i initiative

TIA/CHANGE E2i Implementation Guide (PDF)

A Spanish version of the Implementation Guide is coming soon!

Watch an instructional dramatization of how to deliver TIA/CHANGE to clients.