Computer-Mediated Communication in Adults With and Without Moderate-to-Severe Traumatic Brain Injury: Survey of Social Media Use

Abstract

Background Individuals with a history of traumatic brain injury (TBI) report fewer social contacts, less social participation, and more social isolation than noninjured peers. Cognitive-communication disabilities may prevent individuals with TBI from accessing the opportunities for social connection afforded by computer-mediated communication, as individuals with TBI report lower overall usage of social media than noninjured peers and substantial challenges with accessibility and usability. Although adaptations for individuals with motor and sensory impairments exist to support social media use, there have been no parallel advances to support individuals with cognitive disabilities, such as those exhibited by some people with TBI. In this study, we take a preliminary step in the development process by learning more about patterns of social media use in individuals with TBI as well as their input and priorities for developing social media adaptations. Objective This study aims to characterize how and why adults with TBI use social media and computer-mediated communication platforms, to evaluate changes in computer-mediated communication after brain injury, and to elicit suggestions from individuals with TBI to improve access to social media after injury. Methods We conducted a web-based survey of 53 individuals with a chronic history of moderate-to-severe TBI and a demographically matched group of 51 noninjured comparison peers. Results More than 90% of participants in both groups had an account on at least one computer-mediated communication platform, with Facebook and Facebook Messenger being the most popular platforms in both groups. Participants with and without a history of TBI reported that they use Facebook more passively than actively and reported that they most frequently maintain web-based relationships with close friends and family members. However, participants with TBI reported less frequently than noninjured comparison participants that they use synchronous videoconferencing platforms, are connected with acquaintances on the web, or use social media as a gateway for offline social connection (eg, to find events). Of the participants with TBI, 23% (12/53) reported a change in their patterns of social media use caused by brain injury and listed concerns about accessibility, safety, and usability as major barriers. Conclusions Although individuals with TBI maintain social media accounts to the same extent as healthy comparisons, some may not use them in a way that promotes social connection. Thus, it is important to design social media adaptations that address the needs and priorities of individuals with TBI, so they can also reap the benefits of social connectedness offered by these platforms. By considering computer-mediated communication as part of individuals’ broader social health, we may be able to increase web-based participation in a way that is meaningful, positive, and beneficial to broader social life.

Accessibility of Online Resources for Associations Providing Services to People with Brain Injuries in Covid-19 Pandemic

“…The study of Brunner et al (2017) highlights that information and communication technologies are frequently used for individuals with TBI’s rehabilitation [ 18 ]. However, the current study shows that the resources available online for people with TBI are moderately accessible (accessibility score of 55%) which is consistent with the accessibility concerns reported the participants of Morrow et al (2021) study [ 4 ]. Morrow et al (2021) reported that accessibility, safety and usability remain important barriers for their use of online resources [ 4 ], reinforcing the importance of developing solutions to improve the accessibility of online resources.…”

“…Individuals with TBI have different use patterns for social media, videoconferencing platforms and general internet than non-injured individuals [ 4 ]. They need simplified content, visually accessible with low complexity.…”

“…Among the difficulties that this population encounters, one will note physical, cognitive (e.g., deficit of attention), or psychological challenges [ 1 , 2 , 3 ]. These disabilities affect quality of life [ 1 ], independence and social interactions [ 2 , 4 ]. Thus, many individuals with TBI require long-term support to be able to participate in their community after the end of their rehabilitation [ 5 ].…”

“…However, since March 2020, the beginning of the Covid-19 pandemic in Quebec, many of the services offered by the associations have had to be urgently transferred online or remotely, endangering the indispensable accessibility of community-based services for individuals with a brain injury. This change highlighted a variability among those with TBI regarding the use of digital resources, such as websites [ 4 ]. In fact, while some individuals accessed online services with ease, others faced challenges in doing so and thus were unable to get the services they needed.…”

Facebook Experiences of Users With Traumatic Brain Injury: A Think-Aloud Study

“…For individuals with TBI to benefit from social media use, it is critical to address the barriers they may encounter so we can provide solutions to overcoming those barriers. Studies to date have advanced our understanding of the needs and challenges of adults with TBI but are largely based on retrospective reflection (eg, via self-report surveys) or analysis of previous posts [29,[31][32][33]. Retrospective recall and self-reflection can be particularly challenging for adults with TBI, who commonly have impairments in declarative recall and metacognition [34,35], and analysis of posts does not illuminate the process of accessing social media in real time.…”