Factor structure and measurement invariance of post-concussion symptom ratings on the Health and Behaviour Inventory across time, raters, and groups: An A-CAP study

Zhang, Cherri; Tang, Ken; Zemek, Roger; Beauchamp, Miriam H.; Craig, William; Doan, Quynh; Yeates, Keith Owen

doi:10.1017/s1355617722000340

Cited by 3 publications

(1 citation statement)

References 40 publications

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“…The Health and Behavior Inventory (HBI) and retrospective HBI were used to measure the participant’s preinjury and postinjury symptom profile and severity. The HBI is a 20-item (score range 0 to 60, higher scores indicate increased number of symptoms or more severe symptoms) valid and reliable symptom rating scale recommended as a National Institutes of Health core common data element for concussion .…”

Section: Methodsmentioning

confidence: 99%

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

Ledoux,

Sicard,

Bijelić

et al. 2024

JAMA Netw Open

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ImportanceDetermining the optimal volume of early moderate-to-vigorous-intensity physical activity (MVPA) after concussion and its association with subsequent symptom burden is important for early postinjury management recommendations.ObjectivesTo investigate the association between cumulative MVPA (cMVPA) over 2 weeks and subsequent symptom burden at 1 week, 2 weeks, and 4 weeks postinjury in children and examine the association between cMVPA and odds of persisting symptoms after concussion (PSAC) at 2 weeks and 4 weeks postinjury.Design, Setting, and ParticipantsThis multicenter cohort study used data from a randomized clinical trial that was conducted from March 2017 to December 2019 at 3 Canadian pediatric emergency departments in participants aged 10.00 to 17.99 years with acute concussion of less than 48 hours. Data were analyzed from July 2022 to December 2023.ExposurecMVPA postinjury was measured with accelerometers worn on the waist for 24 hours per day for 13 days postinjury, with measurements deemed valid if participants had 4 or more days of accelerometer data and 3 or fewer consecutive days of missing data. cMVPA at 1 week and 2 weeks postinjury was defined as cMVPA for 7 days and 13 days postinjury, respectively. Multiple imputations were carried out on missing MVPA days.Main Outcomes and measuresSelf-reported postconcussion symptom burden at 1 week, 2 weeks, and 4 weeks postinjury using the Health and Behavior Inventory (HBI). PSAC was defined as reliable change on the HBI. A linear mixed-effect model was used for symptom burden at 1 week, 2 weeks, and 4 weeks postinjury with a time × cMVPA interaction. Logistic regressions assessed the association between cMVPA and PSAC. All models were adjusted for prognostically important variables.ResultsIn this study, 267 of 456 children (119 [44.6%] female; median [IQR] age, 12.9 [11.5 to 14.4] years) were included in the analysis. Participants with greater cMVPA had significantly lower HBI scores at 1 week (75th percentile [258.5 minutes] vs 25th percentile [90.0 minutes]; difference, −5.45 [95% CI, −7.67 to −3.24]) and 2 weeks postinjury (75th percentile [565.0 minutes] vs 25th percentile [237.0 minutes]; difference, −2.85 [95% CI, −4.74 to −0.97]) but not at 4 weeks postinjury (75th percentile [565.0 minutes] vs 25th percentile [237.0 minutes]; difference, −1.24 [95% CI, −3.13 to 0.64]) (P = .20). Symptom burden was not lower beyond the 75th percentile for cMVPA at 1 week or 2 weeks postinjury (1 week, 259 minutes; 2 weeks, 565 minutes) of cMVPA. The odds ratio for the association between 75th and 25th percentile of cMVPA and PSAC was 0.48 (95% CI, 0.24 to 0.94) at 2 weeks.Conclusions and RelevanceIn children and adolescents with acute concussion, 259 minutes of cMVPA during the first week postinjury and 565 minutes of cMVPA during the second week postinjury were associated with lower symptom burden at 1 week and 2 weeks postinjury. At 2 weeks postinjury, higher cMVPA volume was associated with 48% reduced odds of PSAC compared with lower cMVPA volume.

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Section: Methodsmentioning

confidence: 99%

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

Ledoux,

Sicard,

Bijelić

et al. 2024

JAMA Netw Open

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Dynamic Relations Between Psychological Resilience and Post-Concussion Symptoms in Children With Mild Traumatic Brain Injury Versus Orthopedic Injury: An A-CAP Study

Hassan

Brooks

McArthur

et al. 2024

Journal of Neurotrauma

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Do preinjury life events moderate the outcomes of mild traumatic brain injuries in children? An A-CAP Study

Dharsee,

Tang,

Beauchamp

et al. 2024

Journal of Pediatric Psychology

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Objective To examine preinjury life events as moderators of postconcussive symptoms (PCS) and quality of life (QoL) in children with pediatric mild traumatic brain injury (mTBI) versus orthopedic injury (OI). Methods Participants were 633 children with mTBI and 334 with OI, ages 8–16.99, recruited from 5 pediatric emergency departments and followed for 6 months postinjury as part of a prospective cohort study. Preinjury life events were measured retrospectively using the Child and Adolescent Survey of Experiences, PCS using the Health and Behavior Inventory (HBI) and Post-Concussion Symptom Interview (PCS-I), and QoL using the Pediatric Quality of Life Inventory (PedsQL). Analyses involved longitudinal regression using restricted cubic splines, with group, positive and negative life events, and time as primary predictors. Covariates included age, sex, race, socioeconomic status, preinjury history (i.e., headache, migraine, previous concussion), and parent-rated retrospective PCS-I, HBI, and PedsQL scores. Results PCS and QoL were worse after mTBI than OI, but group differences declined with time (all p < .001). Group differences in PCS were larger at higher levels of positive life events, which predicted lower PCS (p= .03 to p < .001) and higher QoL (p = .048) after OI but not after mTBI. Negative life events predicted worse PCS and QoL in both groups (p = .002 to p < .001). Conclusions Preinjury positive life events moderate outcomes after pediatric injury, with a protective effect seen in OI but not in mTBI. Negative life events are consistently associated with worse outcomes regardless of injury type.

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Factor structure and measurement invariance of post-concussion symptom ratings on the Health and Behaviour Inventory across time, raters, and groups: An A-CAP study

Cited by 3 publications

References 40 publications

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

Optimal Volume of Moderate-to-Vigorous Physical Activity Postconcussion in Children and Adolescents

Dynamic Relations Between Psychological Resilience and Post-Concussion Symptoms in Children With Mild Traumatic Brain Injury Versus Orthopedic Injury: An A-CAP Study

Do preinjury life events moderate the outcomes of mild traumatic brain injuries in children? An A-CAP Study

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