New center aims to make the future of trauma survivors brighter

MUSC has been awarded more than $11 million by the National Institute of General Medical Sciences over five years to establish a Center of Biomedical Research Excellence (COBRE) to build resilience after trauma, which will be known as the South Carolina Building Resilience through Innovative Interventions to promote Growth and Health after Trauma COBRE, or the BRIGHT Center. The BRIGHT Center will be directed by clinical psychologist Carla Kmett Danielson, Ph.D., the first woman to lead a COBRE at MUSC. This will also be the first COBRE led by faculty members in the Department of Psychiatry and Behavioral Sciences. Kenneth Ruggiero, Ph.D., of the College of Nursing, will serve as the center’s co-director.

Roughly 3 in 4 Americans experience a potentially traumatic event by age 18, and trauma-related health conditions cost the nation more than $300 billion each year. Although many who experience trauma show resilience, millions more face lifelong mental and physical consequences. Health care systems struggle to deliver scalable, evidence-based treatment where it’s needed most, said Danielson.

The National Alliance on Mental Illness estimates that 1 in 5 Americans experience mental illness each year, but more than half do not receive treatment, usually because of cost or lack of access to care. In 2021, more than 700,000 adults in South Carolina were diagnosed with a mental health condition, and more than 2.3 million South Carolinians lived in communities that did not have enough mental health professionals.

"The wonderful news is that many people show tremendous resilience after experiencing trauma, and there are things we can do to help strengthen that resilience. The BRIGHT Center will build on that strength, instill hope in affected communities and help people to envision a brighter future than they may have thought possible.”

-- BRIGHT Center Director Dr. Carla Kmett Danielson

The BRIGHT Center is trying to better the odds for trauma survivors by equipping a new generation of trauma researchers with state-of-the-art resources and tools so that they can expand the impact and reach of trauma interventions. The center’s overarching goal is to provide early-career investigators with the mentoring and other resources they will need to conduct high-impact trauma research now and in the future. It will support them as they develop and rigorously test innovative treatment and implementation strategies to improve access and quality of care for people affected by trauma and adversity. This support will enable the early-career researchers to advance their projects enough to secure new grant funding, establishing themselves as independent scientists with their own laboratories. This multidisciplinary center will also strengthen MUSC’s biomedical infrastructure in traumatic stress research. Ultimately, the center’s goal is to make a difference in the lives of those affected by trauma in South Carolina and across the nation.

“The BRIGHT Center is meant to serve as a one-stop shop to bring together resources that support people in the early stages of their career in learning how to have the most impact in the field of trauma,” said Danielson. “It will give them the tools to best address the public health crisis we face with the many problematic health outcomes that extend from trauma.”

The name BRIGHT Center was chosen to give hope to those recovering from trauma.

“The wonderful news is that many people show tremendous resilience after experiencing trauma, and there are things we can do to help strengthen that resilience,” said Danielson. “The BRIGHT Center will build on that strength, instill hope in affected communities and help people to envision a brighter future than they may have thought possible.”

The center will make these tools and resources available through three research cores: the Digital Health Core, the Community Engagement Core and the Dissemination and Implementation Science Core. To expand participation in trauma research, these resources will be available not only to the COBRE-supported early-career investigators but also to researchers across MUSC and the state.

The Digital Health Core will ensure that researchers are equipped with the latest in technology, which includes not only mobile applications but also artificial intelligence to make their interventions more efficient, accessible and impactful. This core will be led by Ruggiero, the director of the SmartState Technology Application for Healthful Lifestyles; Jihad Obeid, M.D., Department of Public Health Sciences; and Leigh Ridings, Ph.D., College of Nursing.

The Community Engagement Core will help researchers to tailor their studies and their interventions to the needs of the community. It will teach researchers best practices for engaging with community members, providers and other interested parties to obtain feedback on how to make their studies and interventions resonate with the intended audience. The core will be led by Marvella Ford, Ph.D., Department of Public Health Sciences, and Cristina Lopez, Ph.D., and Colleen Halliday, Ph.D., both of the Department of Psychiatry and Behavioral Sciences.

Finally, the Dissemination and Implementation Science Core will help to improve uptake of interventions by making them easier for providers and communities to roll out effectively.

“Just because you build it doesn't mean they'll come,” said Danielson. “You can build an outstanding intervention that truly works, but it means little unless it reaches the very people it was designed to help.”

The goal of implementation science is to ensure that the intervention reaches those who need it and their providers and is packaged in a way that is relevant for each different clinical setting. This core will be led by Rochelle Hanson, Ph.D., Department of Psychiatry and Behavioral Sciences; Dee Ford, M.D., director of the Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine; and Emily Johnson, Ph.D., College of Nursing.

The first early-career trauma researchers who will receive support for their research projects are Christine Hahn, Ph.D., Department of Psychiatry and Behavioral Sciences; Hannah Espeleta, Ph.D., College of Nursing, who is also a current South Carolina Clinical & Translational Research Institute KL2 scholar; and Guillermo Wippold, Ph.D., Department of Psychology at the University of South Carolina. The threads of digital technology, community engagement and implementation science will run throughout the projects of all funded researchers.

Hahn will be testing the first smartphone application to be used during treatment for traumatic stress and substance misuse in sexual assault centers. Hahn and her mentors at MUSC previously adapted a five-session writing intervention for traumatic stress to include coping skills for substance misuse. With the support of the COBRE grant, they will develop a smartphone application that can help providers to deliver the intervention and offer survivors support in real time through their phones, increasing the access to evidence-based care after sexual assault. 

Espeleta seeks to improve availability of evidence-based home visiting models that deter child maltreatment. Currently, only 3% of high-risk populations, which include residents of rural communities, have access to these home visits. Espeleta is seeking to expand the number of people who can benefit from these visits by developing a hybrid in-person/virtual format and will test the feasibility of this approach in a pilot clinical trial.

Wippold will build a digitized version of a program he developed to address health-related quality of life, for example by encouraging healthier diets and regular exercise. The program also incorporates strategies to combat traumatic stress among men. The use of a mobile application will make it easier to participate in the program and will help to expand its reach.  

By providing support to these early-career investigators and other trauma researchers, Danielson is confident that the BRIGHT Center can make lasting change to trauma care in South Carolina and the nation. Early-career investigators will learn best practices in digital health, community-engaged research and implementation science that will not only help them to maximize the impact of their current studies but will inform all their future lines of research.

“In clinical psychology, one of the first principles you learn is ‘process over content’ as a treatment approach,” said Danielson. “No matter what specific mental health issue you’re addressing, the process of delivering the intervention often looks very similar. The same idea applies to our early-career investigators. Even if their future studies focus on different populations or outcomes, the processes and best practices they learn through the COBRE cores can be applied across their work.”

Danielson hopes that after its first five years of funding, the BRIGHT Center will have made a noticeable dent in the barriers that keep survivors of trauma from accessing care and from fully healing.

“If I could wave a magic wand and look five years into the future, I’d envision the BRIGHT Center as a catalyst for transformative change - closing treatment gaps, not only through innovative interventions but also by revolutionizing how they are implemented across a wide range of care settings and how they are communicated to the communities they are intended to serve,” said Danielson.

For more information about the BRIGHT Center, please contact research program coordinator Charli Kirby.