S.T.R.O.N.G. Families: Provider Training Pilot for Co-Occurring Trauma and Disruptive Behavior Disorders

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Background Urban youth exposed to community violence and structural disadvantage frequently present with co-occurring traumatic stress and disruptive behavior disorders, yet most evidence-based interventions treat these conditions in isolation.Objective This study presents a formative evaluation of provider training for S.T.R.O.N.G. Families (SF) and its Rap music and Hip-Hop cultural adaptation, Hip-Hop H.E.A.L.S. (H3).Method Training evaluation data were collected from 419 youth-serving providers across more than 20 training events in four U.S. states, using the Integrated Services Provider Proficiency Survey for Disruptive Behavior Disorders (ISPPS-DBD) and the National Child Traumatic Stress Network Training Impact and Satisfaction Survey (TISS). Cross-sectional descriptive analyses used available-case reporting.Results Provider-reported training impact and satisfaction were favorable, while the TISS implementation-barrier item received the lowest training-impact rating. The Use–Access–Need gap analysis identified the largest unmet training needs in trauma-focused exposure, motivational enhancement, family safety planning, and family interaction skills. Provider attitudes endorsed evidence-based and integrated practice with low resistance; self-reported routine use of evidence-based interventions and assessment instruments was moderate. Structural barriers were prominent, particularly cross-system coordination and supervision access. Exploratory H3 evaluation data from a small subgroup (n = 9–10) showed moderate ratings with substantial variability and do not support conclusions about effectiveness.Conclusion Findings support the workforce relevance of integrated training for professionals serving urban youth with co-occurring presentations and identify specific skill domains and structural conditions on which sustained implementation depends.