Challenges Associated With Screening for Traumatic Brain Injury Among US Veterans Seeking Homeless Services

Russell, Leah M.; Devore, Maria D.; Barnes, Sean M.; Forster, Jeri E.; Hostetter, Trisha A.; Montgomery, Ann Elizabeth; Casey, Roger; Kane, Vincent; Brenner, Lisa A.

doi:10.2105/ajph.2013.301485

Cited by 25 publications

(22 citation statements)

References 7 publications

(3 reference statements)

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“…The increased number of referrals for clients with complex co-morbidities that affect performance in daily life, such as TBI, was similar to other studies [2]. A major difference in findings of this study is that there does not seem to be role confusion as was reported in a study of perception of occupational therapy by nurses on an inpatient mental health unit [40]. While beyond the scope of the study, this may be influenced by the realities of integrated primary care, where client challenges in executing activities of daily living are routinely demonstrated to team members and the role of occupational therapy is more easily understood, in comparison to an inpatient setting where high acuity and active symptoms of psychosis may restrict the type of real-life interventions and lead to some role confusion.…”

Section: Discussionsupporting

confidence: 76%

“…Additionally, there is increased awareness in those serving homeless persons that TBI specifically is very common and complicates successful housing and other goals. However, there are limited studies addressing the more complex client that is homeless with TBI [4,[28][29][30][31][32][33][34]40].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Several studies have employed performancebased occupational therapy evaluations and cognitive assessments with individuals who are homeless to assess instrumental ADL performance relative to functional cognition, safety, and community living [31,[35][36][37][38][39][40]. These studies demonstrate that occupational therapy evaluation can adequately assess for ongoing functional difficulties, and identify effective treatment plans in order to increase independence for individuals with SMI and TBI.…”

Section: Literature Reviewmentioning

confidence: 99%

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Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

Merryman

Synovec

2020

WOR

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BACKGROUND: Occupational therapists have a long history of addressing community performance and participation challenges faced by individuals with complex, chronic conditions, including those with serious mental illnesses (SMI) and cognitive issues that present with a traumatic brain injury (TBI). Healthcare reform has shifted incentives to support practices that promote successful community life for people with complex medical conditions. Community based care models emphasizing integrated primary care, such as Federally Qualified Health Centers (FQHC) are emerging, and a generalist role for occupational therapy is being defined. Those with complex comorbid conditions such as mental illness, substance abuse and traumatic brain injury are at risk for negative health outcomes that are further compounded by homelessness. There is a critical need to understand effective treatment options for this population to reduce the negative effects of chronic health conditions. As occupational therapists further define a role serving traditional clients in less traditional settings, such as the FQHC, it is helpful to explore the perceptions of the utility of OT services on the part of provider referrers. OBJECTIVE: This study explored provider referrer perceptions of a new occupational therapy service for homeless adults in an FQHC to assist effective allocation of scarce resources. METHODS: Twelve provider referrers at an FQHC were interviewed regarding their perception of the role and utility of occupational therapy in this setting. Interviews were then coded for themes. RESULTS: Providers identified the unique value of occupational therapy, emphasizing critical information gleaned from the performance-based assessment of functional cognition, and the positive impact on team interactions and subsequent care decisions. CONCLUSION: Occupational therapy provides a distinct perspective on client performance in FQHC settings indicating benefit for inclusion of services.

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Section: Discussionsupporting

confidence: 76%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

Merryman

Synovec

2020

WOR

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“…As demonstrated here, the BISQ not only meets these minimal requirements but is also relatively brief, easy to administer in a wide range of settings and populations, has good construct validity and criterion validity, 40,43,68,69 and appears to be more sensitive to comprehensive TBI history than many existing measures. 56,57,59,87 The BISQ is not without limitations, and other tools may be more appropriate in some settings. A report on a subset of results of large-scale expansion of the initial BISQ validation study 63 is currently under review.…”

Section: Discussionmentioning

confidence: 99%

“…For example, some studies suggest that single-item questions about TBI history miss more than 35% of the individuals found to have sustained a TBI via a subsequent structured interview. 56,57 Carefully worded single-item queries can of course provide valuable data in large-scale health outcomes studies designed to evaluate the association of TBI with other health issues or behaviors but do not suffice for estimating TBI prevalence.…”

Section: Methods For Tbi Screeningmentioning

confidence: 99%

Screening for Traumatic Brain Injury

Dams-O’Connor¹,

Cantor²,

Brown³

et al. 2014

Journal of Head Trauma Rehabilitation

112

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Objective To provide an overview of a series of projects that used a structured self-report screening tool in diverse settings and samples to screen for lifetime history of traumatic brain injury (TBI). Setting Diverse community settings. Participants Homeless persons (n = 111), individuals with HIV seeking vocational rehabilitation (n = 173), youth in the juvenile justice system (n = 271), public schoolchildren (n = 174), substance users (n = 845), intercollegiate athletes (n = 90), and other community-based samples (n = 396). Design Cross-sectional. Main Measure Brain Injury Screening Questionnaire. Results Screening using the Brain Injury Screening Questionnaire finds that 27% to 54% of those in high-risk populations report a history of TBI with chronic symptoms. Associations between TBI and social, academic, or other problems are evident in several studies. In non–high-risk community samples, 9% to 12% of individuals report TBI with chronic symptoms. Conclusion Systematic TBI screening can be implemented efficiently and inexpensively in a variety of settings. Lifetime TBI history data gathered using a structured self-report instrument can augment existing estimates of the prevalence of TBI, both as an acute event and as a chronic condition. Identification of individuals with TBI can facilitate primary prevention efforts, such as reducing risk for reinjury in high-risk groups, and provide access to appropriate interventions that can reduce the personal and societal costs of TBI (tertiary prevention).

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Linguistic and Cultural Acceptability of a Spanish Translation of the Ohio State University Traumatic Brain Injury Identification Method Among Community-Dwelling Spanish-Dominant Older Adults

Hufstedler

Dorsman

Rivera

et al. 2019

Archives of Rehabilitation Research and Clinical Translation

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Objective Our objective was to (1) evaluate the linguistic and cultural acceptability of a Spanish translation of the Ohio State University traumatic brain injury identification method (OSU TBI-ID) and (2) to assess the usability and acceptability of a tablet-based version of this instrument in a cohort of Spanish-dominant older adults. Setting University clinical research center and local community center. Participants Community-dwelling Spanish-dominant adults age 50 years or older without dementia residing in the Bay Area of California (N=22). Design Cross-sectional cohort study. Main Outcome Measures Qualitative assessment of linguistic or cultural acceptability of a Spanish translation of the OSU TBI-ID as well as usability or acceptability of a tablet-based self-administered version of this instrument. Results The Spanish translation had high linguistic and cultural acceptability and was further optimized based on participant feedback. Cognitive interviews to review survey wording revealed high levels of homogeneity in the clinical definitions and synonyms given by participants—for example, results for the clinical term “ Quedó Inconsciente/Pérdida ( temporal ) de la conciencia ” ( To be unconscious/ [ Temporary ] loss of consciousness ) used in the survey included “ perder el conocimiento ” ( loss of consciousness ), “ knockeado ” ( knocked out ), “ No es que esté dormida, porque está inconsciente, pero su corazón está todavía palpitando ” ( it’s not that they’re sleeping, because they’re unconscious, but their heart is still palpitating ) . The tablet interface had low observer-based usability, revealing that participants with <13 years of education (n=6) had more difficulty using the tablet which could be improved with minor changes to the coding of the application and minimal in-person technology support. Acceptability of the tool was low among all but 1 participant. Conclusion This linguistically optimized Spanish translation of the OSU TBI-ID is recommended for use as a semistructured interview among Spanish-dominant older adults. Although the tablet-based instrument may be used by interviewers as an efficient electronic case report form among older adults, further research is needed, particularly among older adults with varying levels of education, to validate this instrument as a self-administered survey.

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Challenges Associated With Screening for Traumatic Brain Injury Among US Veterans Seeking Homeless Services

Cited by 25 publications

References 7 publications

Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

Screening for Traumatic Brain Injury

Linguistic and Cultural Acceptability of a Spanish Translation of the Ohio State University Traumatic Brain Injury Identification Method Among Community-Dwelling Spanish-Dominant Older Adults

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