Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Moore, Megan; Jimenez, Nathalia; Graves, Janessa M.; Rue, Tessa; Fann, Jesse R.; Rivara, Frederick P.; Vavilala, Monica S.

doi:10.1097/htr.0000000000000348

Cited by 12 publications

(6 citation statements)

References 36 publications

(35 reference statements)

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“…Although much academic investigation focuses on differences in health service access or use according to race, it often stops short of naming racism as culpable even when implicated. 65–67…”

Section: Discussionmentioning

confidence: 99%

Racism in Health Services for Adolescents: A Scoping Review

Hilario

Louie-Poon

Taylor

et al. 2023

International Journal of Social Determinants of Health and Heal

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Addressing racism within health systems and services is critical to addressing health vulnerabilities and promoting health equity for racialized populations. Currently, there is limited knowledge about the ways in which racism affects health services for adolescents. A scoping review was undertaken following the Joanna Briggs Institute Manual for Evidence Synthesis methodology and guided by the research questions: (1) What are the characteristics of the literature examining racism in health service use for adolescents? (2) What are the foci of the literature on systemic racism and health services for adolescents? A systematic literature search was conducted in April 2021 to identify all relevant published studies. The search identified 3049 unique articles, with a total of 13 articles included in this review. Multiple levels of racism were examined in the included articles across various health care settings. Five foci were identified: racism prevention, missed care, quality of care, racial bias, and experiences of racism. Our review indicates a current emphasis on interpersonal racism within this field of study, with emergent discussion of the impact of systemic racism. However, greater attention is needed that would investigate multiple forms of racism (institutional, interpersonal, internalized) in relation to specific contexts and adolescent populations.

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Section: Discussionmentioning

confidence: 99%

Racism in Health Services for Adolescents: A Scoping Review

Hilario

Louie-Poon

Taylor

et al. 2023

International Journal of Social Determinants of Health and Heal

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“…23 TBI severity was determined by Glasgow Coma Scale (GCS) at the time of admission to the acute care hospital. We included patients with complicated mild (GCS score 13-15 with skull fracture or intracranial blood on imaging), moderate (GCS score 9-12), and severe TBIs (GCS score [3][4][5][6][7][8]. Patients who suffered polytrauma with TBI were included in the study.…”

Section: Methodsmentioning

confidence: 99%

“…treatments due to insurance, geographical, and communication barriers. [2][3][4][5] Facilitating access to post-TBI care for Hispanic children is important. Parent-reported data from the 2016 National Health Interview Survey show that approximately 6% of Hispanic children between 3 and 17 years of age have ever had a significant TBI.…”

mentioning

confidence: 99%

“…Compared with their non-Hispanic peers, they report lower health-related quality of life, reduced participation in social activities, and lower communication and self-care abilities after TBI 1. They are also less likely to receive long-term rehabilitation treatments due to insurance, geographical, and communication barriers 2–5. Facilitating access to post-TBI care for Hispanic children is important.…”

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confidence: 99%

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Feasibility and Acceptability of a Telephone-Based Intervention for Hispanic Children to Promote Treatment Adherence After Traumatic Brain Injury: A Pilot Study

Jimenez

Fuentes

Virtue

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective: To assess the feasibility and acceptability of a telephone-based education and navigation program for Hispanic parents of children hospitalized with traumatic brain injury (TBI). Setting: Level I trauma hospital and pediatric inpatient rehabilitation unit in the Northwestern United States. Participants: Fourteen Hispanic parentchild dyads. Parents were 85% female, with a mean age of 35 years. Children were 58% male, with a mean age of 9.7 years, and had been hospitalized for complicated mild/moderate (n = 5) or severe (n = 9) TBI. Design: Pilot prospective cohort design. Main Measures: Feasibility measures include recruitment, retention, and intervention adherence rates. Acceptability of intervention was measured by parents' use of educational materials and satisfaction with navigation program. We also evaluated study processes, including completion of baseline, 3, 6, and 12 months functional assessments of the child; assessment of parental health literacy and self-efficacy; and adherence to followup rehabilitation appointments. Results: Eighty-two percent of approached potential participants were recruited into the study. One hundred percent of participants completed the intervention, and 85% had 1-year follow-up. Intervention acceptability was high: 90% reported satisfaction with navigator, and 92% used the educational manual. Assessments demonstrated significant improvement in parents' TBI caregiving and community self-efficacy; 92% attendance to follow-up rehabilitation appointments; and improvement in the child's functional measures, except communication skills. Conclusions: Findings support feasibility and acceptability of a culturally relevant program to facilitate transitions of care for Hispanic children with TBI. A future randomized trial is warranted to determine the efficacy of the intervention on long-term treatment adherence and the child's post-TBI function.

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“…However, caregiver functioning can influence outcomes after TBI, and therapies for persons who have sustained TBI can improve caregiver distress. Socioeconomic differences, including race/ethnicity and urban/rural residence, are associated with outcomes after TBI, [19][20][21][22][23] including depression, anxiety, poor life satisfaction, limited access to outpatient care, worse neurocognitive performance, and higher mortality. However, it is not well described whether the burden among caregivers of persons with TBI is associated with racial/ethnic differences.…”

Section: Introductionmentioning

confidence: 99%

Race/Ethnicity and Informal Caregiver Burden After Traumatic Brain Injury: A Scoping Study

et al. 2020

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Background: Informal caregivers for persons with traumatic brain injury (TBI) face a range of unique issues, and racial/ethnic group differences in caregiver challenges are poorly understood. We undertook a scoping study of peer-reviewed literature to assess the quantity and quality of available research describing differences by race/ethnicity in informal caregiving roles and burden. Methods: Using Arksey and O'Malley's framework and guided by the Preferred Reporting Items of Systematic Reviews and Meta-analyses Extension for Scoping Reviews, we conducted electronic searches of PubMed, CINAHL, PsycARTICLES, PsycINFO, Social Work Abstracts, Embase, and Scopus to identify peer-reviewed studies that examined TBI informal caregiver burden and reported on the influences of race or ethnicity. Results: Among 4523 unique publications identified and screened, 11 studies included sufficient race/ethnicity data and were included in the analysis. Of these, six studies described civilian populations and five described military Veterans Affairs (VA). Included studies revealed that nonwhite caregivers and white caregivers use different approaches and coping strategies in their caregiving role. Some studies found differences in caregiver burden by race or ethnicity, others did not. Most were limited by a small sample size and overdependence on assessment tools not validated for the purposes or populations for which they were used. This was particularly true for race/ethnicity as a factor in TBI caregiver burden in VA groups, where essential characteristics moderate the association of race/ethnicity with socioeconomic factors. Conclusions: This scoping study highlights the paucity of information on race/ethnicity as a factor in TBI caregiver burden and roles, and suggests that innovative and alternative approaches to research are needed to explore needed changes in practice.

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Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Cited by 12 publications

References 36 publications

Racism in Health Services for Adolescents: A Scoping Review

Racism in Health Services for Adolescents: A Scoping Review

Feasibility and Acceptability of a Telephone-Based Intervention for Hispanic Children to Promote Treatment Adherence After Traumatic Brain Injury: A Pilot Study

Race/Ethnicity and Informal Caregiver Burden After Traumatic Brain Injury: A Scoping Study

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