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Nurses need a pragmatic theory to understand and respond to the impact of vulnerable patients’ previous healthcare experiences, as these are likely to influence response and adherence to treatment plans. The authors of this paper present the new BITTEN (Betrayal history by health-related institutions, Indicator for healthcare engagement, Traumas related to healthcare, Trust in healthcare providers, patient Expectations and Needs) Model of Trauma-Informed Healthcare. BITTEN identifies patients’ current healthcare expectations and needs as a function of their previous betrayal by healthcare systems, which operates in conjunction with their current health indicators to potentially trigger trauma symptoms and impact trust in healthcare providers.

Aims A mixed‐methods study details a multidisciplinary team's efforts to assess and transform police response to sexual assault in a mid‐size community. Method A police department‐wide survey (n = 331) determined baseline levels of officer exposure to trauma‐informed training, rape myth acceptance, and awareness of community and nationwide sexual assault movements to understand officer attitudes towards factors influencing sexual assault investigations. These data, in conjunction with SAMHSA's (2012) trauma‐informed assumptions, were leveraged to develop and adopt trauma‐informed policies that would enhance the police department's response to sexual assault. Results At baseline, few officers reported receiving trauma‐informed interviewing training (21.8%) or having knowledge of local SAK, #MeToo, or #TimesUp movements (10.0%, 7.2%, 3.9%, respectively). Chi‐square analyses suggested officer knowledge of community SAK movement, personal investment in learning about sexual assault, and understanding of trauma were higher in officers with versus without training; of concern, officers with more sexual assaults on their caseload were more likely to endorse rape myths. Training understanding was related to lower rape myth acceptance. Conclusions Policy changes, including adding trauma‐informed training to the Police Academy, were implemented by the MDT to promote a system‐wide trauma‐informed approach to sexual assault and ensure community safety.

Federally Qualified Health Centers (FQHCs) are a fastgrowing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the "3 E" conceptualization of trauma, certain Event-and Experience-related characteristics of a trauma predict victims' physical and mental health Effects. The "3 Es" have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event-related factors (e.g., cumulative trauma by victim-perpetrator relationship), Experience-related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S.