Addressing brain injury in health care for the homeless settings: A pilot model for provider training

Rehabilitation among individuals experiencing homelessness and traumatic brain injury: A scoping review

“…After duplicates were removed, 4,439 titles and abstracts (227 non-English language) were (47,48,53). None of the rehabilitation programs or interventions were based at an inpatient or outpatient rehabilitation setting; 17 of 18 articles described communitybased rehabilitation that were offered through community organization healthcare clinics (45,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62) or mobile clinic (54), while one article described a medical respite program that provided care to individuals onsite (46).…”

“…In articles that did not explicitly focus on individuals experiencing both homelessness and TBI, the proportion of individuals with TBI ranged from 2.4 to 84% and the proportion of individuals experiencing homelessness ranged from 1.2 to 100%. The majority of articles did not define how TBI was ascertained, with the exception of three articles that screened for self-reported TBI using the Ohio State University Traumatic Brain Injury Identification Method (OSU-TBI-ID) (46,51,57) and one article through face-to-face interviews (59). None of the articles reported injury severity.…”

“…Fourteen articles defined homelessness as part of their inclusion criteria, description of the study sample, or study setting ["absolutely or precariously housed" (55,56,58,59), "experiencing homelessness" (45), "doubling up-friends and family" (62), "shelter, unsheltered, doubled-up" (54) "residing in homeless shelter or on the street" (47,48,51), "scattered site apartments" (45), "respite program" (46), "transitional housing" (62) or participants were referred to as "homeless individuals" (49,50,52,53,57)]. Six articles reported participants intersected with the justice system [i.e., "ever been to jail" (45), "ever been to prison" (45), "arrested in the past" (58), "arrests in the past 6 months" (56), "times in jail/prison" (49), "had prior justice involvement" (60, 61)], with prevalence ranging from 16 to 80% (45,49,56,58,60,61).…”

“…Community health workers implemented treatment plans developed by the OTs and provided supports to patients, both direct (e.g., transportation, paperwork) and relational (e.g., maintaining positive recovery environment, developing rapport with patients). Synovec and Berry described a study on screening and provider training at a healthcare clinic (51). Comprehensive care in terms of services, such as medical, mental health, case management, occupational therapy, dental services, and supportive housing were provided.…”

“…All four articles integrated TBI care in their programs or interventions through TBI screening (46,51,57,59) and/or tailoring interventions to accommodate for TBI impairments that are often cognitive in nature (46,51,57). Face-to-face interviews were conducted (59) or the OSU-TBI-ID (46,51,57) were administered by trained healthcare professionals, including case managers from varying disciplinary backgrounds, OTs, and social workers, to screen for TBI.…”