Evaluation of a 12-month lifestyle intervention by individuals with traumatic brain injury.

Abstract

Weight gain and inactivity are common problems for individuals living with a traumatic brain injury (TBI). Yet, interventions to support a healthy lifestyle specific to individuals with TBI are lacking. The purpose of this study was to complete a program evaluation of a 12-month evidence-based healthy lifestyle intervention adapted for people with a TBI. Eighteen participants completed a brief interview after the yearlong intervention to determine their perceptions of the program effectiveness as well as barriers and facilitators in making lifestyle changes. Participants reported staff, tracking of dietary and activity behavior, and in-person meetings as most helpful aspects. Lack of motivation and difficulty preparing healthy meals were the primary barriers to a healthy lifestyle. Qualitative data revealed five themes that influenced healthy behaviors, including (1) self-regulation, (2) environmental resources, (3) knowledge of health behaviors, (4) TBI-related impairment and comorbidities, and (5) social support. Results suggest that future iterations of the healthy lifestyle intervention should emphasize self-regulation activities; require tracking of dietary and activity behaviors across 12 months; provide concurrent support for individual motivation issues; provide prepared meals; utilize web-based, telephonic, or hybrid approaches to delivery; further simplify the curriculum and learning tools; and include caregivers and peer accountability partners. Impact and ImplicationsThis program evaluation of an evidence-based weight loss intervention modified to meet the unique needs of people with traumatic brain injury (TBI) provides valuable quantitative and qualitative data on participants' perceived helpfulness, barriers, and supports to participation. Program evaluation results following the 12-month intervention suggest that self-regulation, environmental resources, knowledge of health behaviors, TBI-related impairment and comorbidities, and social support are important factors to consider for implementing lifestyle change with this population. Future adaptations of this evidence-based lifestyle intervention should consider emphasizing self-regulation and dietary tracking activities throughout the program, providing additional support for those with mood disorders, and addressing transportation and environmental barriers by providing prepared meals or web-based access for sessions to meet the needs of people with TBI.

A randomized controlled trial protocol for people with traumatic brain injury enrolled in a telehealth delivered diabetes prevention program (tGLB-TBI)

“…We will use means and standard deviations to summarize continuous data and counts and percentages to summarize categorical data. All open-ended, qualitative data from participant Exit Surveys collected directly in REDCap will be evaluated using investigator triangulation to increase validity and rigor [ 55 ], which our team successfully used with our previous Exit Survey [ 56 ].…”

A meta-synthesis of individual, interpersonal, and systemic factors impacting resilience after traumatic brain injury.

“…Individuals with TBI benefited from the availability of reliable information on the consequences of TBI, ways of accessing support resources, and education on strategies to minimize TBI-related changes in functioning (Jones & Curtin, 2011;Fadyl et al, 2017;McPherson et al, 2018). Consistent with the common impression that TBI could provide a "fresh start," many also valued educational resources on healthy lifestyle behaviors (e.g., diet, exercise, stress management) (Douglas et al, 2019). In addition, the availability of continued support from heathcare providers and health care settings were viewed as a crucial resource to promote resilience (Fadyl et al, 2017;Hux et al, 2010).…”