Using an integrated knowledge translation approach to inform a pilot feasibility randomized controlled trial on peer support for individuals with traumatic brain injury: A qualitative descriptive study

Lau, Stephanie Ka Ching; Luong, Dorothy; Sweet, Shane N; Bayley, Mark; Levy, Ben; Kastner, Monika; Nelson, Michelle; Salbach, Nancy M.; Jaglal, Susan; Shepherd, John; Wilcock, Ruth; Thoms, Carla; Munce, Sarah

doi:10.1371/journal.pone.0256650

Cited by 13 publications

(18 citation statements)

References 37 publications

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“…This suggests that motivational problems rooted in psychological mechanisms may be attenuated through peer-assisted activities. Similar outcomes about the ways in which community-based peer-support programs can have a positive impact on recovery after TBI through acceptance and encouragement have been identified (30). Our findings extend those results with the positive influence that peers can have on motivation to participate in health-related PA behaviors in the community after moderate-to-severe TBI.…”

Section: Discussionsupporting

confidence: 85%

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

Quilico

Wilkinson

Duncan

et al. 2022

Front. Rehabilit. Sci.

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BackgroundResearch about using physical activity (PA) to improve health, quality of life, and participation after moderate-to-severe traumatic brain injury (TBI) is receiving growing attention. However, best-practices for maintaining PA participation after TBI have yet to be defined. In this context, a team of researchers and stakeholders with a moderate-to-severe TBI (including program participants and peer mentors) participated in a co-creation process to optimize a 9-month, 3-phased, community-based, adapted PA program named TBI-Health.PurposeThe study aimed to provide a detailed account of the participation in and co-creation of a new TBI-Health Program to enhance sport and exercise participation for adults with moderate-to-severe TBI. Specifically, we carried out an in-depth exploration of the perceived experiences and outcomes of users over one cycle of the program to assist the co-creation process.MethodsAn interpretive case study approach was used to explore the experiences and outcomes of the participatory co-creation within and across phases of the TBI-Health program. A purposeful sample of fourteen adults with moderate-to-severe TBI (program participants n = 10; peer mentors n = 4) were involved in audio-recorded focus groups after each program phase. Reflexive thematic analyses within and across the phases identified three higher-order themes.ResultsProgram Participation included barriers, facilitators, sources of motivation and suggested modifications to optimize the program; Biopsychosocial Changes highlighted perceived physical, psychological, and social outcomes, by self and others, that resulted from program participation; PA Autonomy emphasized transitions in knowledge, sex- and gender-related beliefs, and abilities related to exercise and sport participation.ConclusionsStudy findings suggest the TBI-Health program can increase autonomy for and reduce barriers to PA for adults with moderate-to-severe TBI, which results in increased PA participation and important physical, psychological, and social benefits. More research is needed about the TBI-Health program with larger samples.

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Section: Discussionsupporting

confidence: 85%

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

Quilico

Wilkinson

Duncan

et al. 2022

Front. Rehabilit. Sci.

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“…Our feasibility study identified that peer support was acceptable to mentors and mentees, with numerous perceived benefits, indicating a high potential for effectiveness and likelihood of improving outcomes. These findings are consistent with those more recently reported by Lau et al , 21 whose qualitative descriptive study was also performed to support a randomised controlled trial on peer support after brain injury.…”

Section: Introductionsupporting

confidence: 92%

Randomised pragmatic waitlist trial with process evaluation investigating the effectiveness of peer support after brain injury: protocol

et al. 2023

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IntroductionTraumatic brain injury (TBI) is an important global health problem. Formal service provision fails to address the ongoing needs of people with TBI and their family in the context of a social and relational process of learning to live with and adapt to life after TBI. Our feasibility study reported peer support after TBI is acceptable to both mentors and mentees with reported benefits indicating a high potential for effectiveness and likelihood of improving outcomes for both mentees and their mentors.ObjectivesTo (a) test the effectiveness of a peer support intervention for improving participation, health and well-being outcomes after TBI and (b) determine key process variables relating to intervention, context and implementation to underpin an evidence-based framework for ongoing service provision.Methods and analysisA randomised pragmatic waitlist trial with process evaluation. Mentee participants (n=46) will be included if they have moderate or severe TBI and are no more than 18 months post-injury. Mentor participants (n=18) will be people with TBI up to 6 years after injury, who were discharged from inpatient rehabilitation at least 1 year prior. The primary outcome will be mentee participation, measured using the Impact on Participation and Autonomy questionnaire after 22 weeks. Primary analysis of the continuous variables will be analysis of covariance with baseline measurement as a covariate and randomised treatment as the main explanatory predictor variable at 22 weeks. Process evaluation will include analysis of intervention-related data and qualitative data collected from mentors and service coordinators. Data synthesis will inform the development of a service framework for future implementation.Ethics and disseminationEthics approval has been obtained from the New Zealand Health and Disability Ethics Committee (19/NTB/82) and Auckland University of Technology Ethics Committee (19/345). Dissemination of findings will be via traditional academic routes including publication in internationally recognised peer-reviewed journals.Trial registration numberACTRN12619001002178.

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“…Specifically, they can enact antistigma initiatives for TBI that include narratives of TBI survivors experiences, “myth busting” information, and a discussion of the impact of stigma on prejudiced labeling and behaviors (Szeto & Dobson, 2010; Tsatsou, 2021; Werner & Scior, 2016). Sytems should consider implementing peer support or mentoring programs to reduce both isolation and stigma (Lau et al, 2021), as well as increase the presence of in-person and remote support groups, group-based interventions, and group-based community reintegration activities (e.g., walking group) (Chouliara & Lincoln, 2016; Neumann et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

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

Bannon¹,

Fishbein²,

Lovette³

et al. 2022

Rehabilitation Psychology

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Purpose/Objective: Traumatic brain injuries (TBIs) are increasingly common and a major cause of death and long-term disability. Many individuals experience chronic stressors and adverse health outcomes, emphasizing the importance of cultivating resilience, (defined herein as individual, social, and systemic components engaged in response to the stressors that allow individuals to “bounce back,” or move forward adaptively after TBI). Patients’ perceptions of factors influencing resilience are critical to guide interventions that meet their needs. Here we offer the first metasynthesis of factors influencing resilience after TBI using a Social Ecological model framework. Research Methods/Design: We preregistered our metasynthesis on PROSPERO (CRD42021233975) and followed PRISMA guidelines. We searched 4 electronic databases for qualitative studies from inception up until June 2021. We included qualitative studies detailing perspectives of individuals with a history of moderate-severe TBI. We excluded case studies and systematic reviews. After removal of duplicates, we identified 124 articles for screening. We reviewed 49 articles for full text eligibility and included 38 studies. We extracted study characteristics and data (e.g., author interpretations and relevant quotes) relating to factors influencing resilience. Results: We synthesized findings using a Social Ecological model framework to guide thematic analysis. Persons with TBI identified barriers and facilitators to resilience at individual (e.g., physical and cognitive challenges, coping behaviors), interpersonal, (e.g., stigma and isolation) and systemic (e.g., access to resources, rehabilitation support) levels. Conclusions/Implications: Considering multifaceted factors at individual, interpersonal and systemic levels in clinical, research, and policy-setting contexts is important for cultivating resilience and optimizing recovery after TBI.

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Using an integrated knowledge translation approach to inform a pilot feasibility randomized controlled trial on peer support for individuals with traumatic brain injury: A qualitative descriptive study

Cited by 13 publications

References 37 publications

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

Participatory co-creation of an adapted physical activity program for adults with moderate-to-severe traumatic brain injury

Randomised pragmatic waitlist trial with process evaluation investigating the effectiveness of peer support after brain injury: protocol

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

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