Implementation of a trauma-informed care initiative at FQHCs in Texas.

Introduction: Trauma-informed care recognizes the high prevalence and impact of trauma across the healthcare continuum, and its implementation across healthcare settings has varied. We describe the development and implementation of a trauma-informed care initiative at community health centers across Texas. Methods: Using an inquiry-based learning approach, a train-the-trainer model disseminated trauma-informed principles across participating health centers. This approach was evaluated using formative, summative, and organizational assessments as well as qualitative interviews with trained staff. Results: 34 health centers participated in the trauma-informed care initiative. We observed significant improvements in organizational assessment subdomains and an average score of 73.9% in summative assessments. Trained staff shared difficulties related to learner engagement, time, leadership buy-in, and self-efficacy to train others, however, successes included enhanced cross-departmental collaboration and incorporation of trauma-informed principles in everyday practice. Discussion: Trauma-informed care has the potential to transform healthcare delivery to ensure staff, patient, and organizational wellbeing. We describe a novel approach to implementing trauma-informed care at health centers that shows promise for organizational transformation. Future programs should consider pre-post knowledge assessments, leadership engagement, and sustainability methods such as certifications or continuing education.