Rehabilitation among individuals experiencing homelessness and traumatic brain injury: A scoping review

Abstract

Traumatic brain injury (TBI) is disproportionately prevalent among individuals experiencing homelessness. While rehabilitation is critical to facilitating recovery after TBI, there is currently limited information on the extent to which rehabilitation is provided to individuals experiencing homelessness and TBI. If unaddressed, this knowledge gap can perpetuate TBI-related challenges and contribute to a repetitive cycle of TBI and homelessness. This scoping review explored the extent to which rehabilitation, including the types of rehabilitation interventions, are available to, or used by, individuals experiencing homelessness and TBI. A systematic search of electronic databases (MEDLINE, Embase, Cochrane CENTRAL Register of Clinical Trials, CINAHL, APA PsycINFO, Applied Social Sciences Index and Abstracts, and Proquest Nursing and Allied Health) was conducted to identify peer-reviewed articles that met predetermined eligibility criteria. Gray literature and reference lists of eligible articles were also searched for relevant content. A descriptive numerical summary of extracted data was conducted, and qualitative analytic techniques were applied to analyze the data. Fifteen peer-reviewed articles and three gray literature reports were included, describing interventions for individuals experiencing homelessness and TBI (N = 4), rehabilitation for individuals experiencing homelessness without specific inclusion criteria for TBI (N = 11), and rehabilitation interventions that included individuals experiencing homelessness and TBI, without specific inclusion criteria for experiences of homelessness or TBI (N = 3). This review demonstrates that rehabilitation programs or interventions for this population already exist, and those that are focused on individuals experiencing homelessness are already serving individuals with TBI. Findings highlight opportunities to adapt existing rehabilitation for individuals who experience homelessness and TBI through screening for TBI, conducting cognitive and functional assessments, and tailoring interventions with multidisciplinary teams. Education and training for healthcare professionals working with individuals experiencing homelessness and TBI should be explored, including structured education and training, collaboration with a multidisciplinary team, and co-development of educational materials with service users. Research that considers the rehabilitation needs of diverse individuals experiencing homelessness and TBI is urgently needed.

Exploring the Relationships Between Rehabilitation and Survivors of Intimate Partner Violence: A Scoping Review

“…In all, 10 databases were identified in collaboration with an information specialist (JB) and searched for relevant articles using a search strategy including text words and subject headings (e.g., MeSH, Emtree) related to IPV and rehabilitation (see Appendix I). Search terms were informed by previous reviews exploring IPV ( Toccalino et al, 2023 ) or the role of rehabilitation professionals ( Chan, Estrella, Baddeliyanage, et al, 2022 ; Chan, Estrella, Syed, et al, 2022 ). The search strategy was first developed in Medline (see Appendix I) and subsequently translated to the databases.…”

Rehabilitation among individuals with traumatic brain injury who intersect with the criminal justice system: A scoping review

“…The search strategy for this scoping review was informed by previous scoping and systematic reviews (38)(39)(40) and developed in collaboration with an Information Specialist (JB) and team members with research and content expertise in TBI, CJS, and rehabilitation (VC, MJE, AC). The strategy for MEDLINE R ALL (in Ovid, including Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily) database was first developed and subsequently translated to: Embase and Embase Classic (Ovid), Cochrane CENTRAL Register of Clinical Trials (Ovid), CINAHL (EBSCO), APA PsycINFO (Ovid), Applied Social Sciences Index and Abstracts (Proquest), Criminal Justice Abstracts (EBSCO), and Nursing and Allied Health (Proquest).…”

“…Such intervention plans included psychoeducation on TBI and its consequences; strategies and functional aids to address TBIrelated impairments; and modifications to interventions. The need for screening is not new and has been highlighted in studies that focused on underserved populations with TBI (40,(75)(76)(77)(78)(79). Unfortunately, despite literature supporting the need for TBI screening, almost half of the articles identified in this review did not specify how TBI was ascertained.…”

Exploring the Role of Rehabilitation Medicine Within an Inclusion Health Context: Examining a Population at Risk From Homelessness and Brain Injury in Edinburgh

“…into the rehabilitation needs of people experiencing homelessness has demonstrated high levels of physical limitation, cognitive and functional impairments. A scoping review also demonstrated there are existing programmes of rehabilitation targeting this population with opportunities to further tailor existing services to better meet the needs of people experiencing homelessness [18][19][20][21]. Policy guidance regarding the health of people experiencing homelessness, is clear that identification of brain injury, and management of its sequelae should be priority areas in inclusion health efforts [2,18].…”