Race/Ethnicity and Community Participation Among Veterans and Service Members With Traumatic Brain Injury: A VA Traumatic Brain Injury Model Systems Study. Issue 6 (22nd November 2021)

• Record Type: Journal Article
• Authors: Stevens, Lillian Flores; Ketchum, Jessica M.; Sander, Angelle M.; Callender, Librada; Dillahunt-Aspillaga, Christina; Dreer, Laura E.; Finn, Jacob A.; Gary, Kelli W.; Graham, Kristin M.; Juengst, Shannon B.; Kajankova, Maria; Kolakowsky-Hayner, Stephanie; Lequerica, Anthony H.; Rabinowitz, Amanda R.
• Is Part Of: Journal of head trauma rehabilitation. Volume 36:Issue 6(2021)
• Page Start: 408
• Page End: 417
• Publication Date: 2021-11-22
• Subjects: community participation -- military personnel -- racial disparities -- traumatic brain injuries -- veterans; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000657
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Supplemental Digital Content is Available in the Text. Abstract : Objective: To examine racial/ethnic disparities in community participation among veterans and active duty service members with traumatic brain injury (TBI). Setting: Five Department of Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs). Participants: Three hundred forty-two community-dwelling adults (251 White, 34 Black, and 57 Hispanic) with TBI enrolled in the VA TBIMS National Database who completed a 1-year follow-up interview. Mean age was 38.6 years (range, 19-84 years). Design: Cross-sectional analysis of a prospective observational cohort study. Main Measures: Community participation at 1 year postinjury assessed by 3 domains of the Participation Assessment with Recombined Tools–Objective (PART-O): Out & About, Productivity, and Social Relations. Results: Significant differences were observed among race/ethnicity groups in PART-O Productivity and Out & About domains without controlling for relevant participant characteristics; Productivity scores were significantly higher for non-Hispanic Black than for non-Hispanic White participants ( t = 2.40, P = .0169). Out & About scores were significantly higher for Hispanic than for non-Hispanic White participants ( t = 2.79, P = .0056). However, after controlling for demographic, injury severity, and 1-year follow-up characteristics, only differences in the Out & About domain remained statistically significant ( t = 2.62, P = .0094), with scores being significantly higher for Hispanics than for non-Hispanic Whites. Conclusions: The results, which differ from findings from studies conducted in non-VA healthcare settings where there are greater racial/ethnic disparities in participation outcomes, could reflect differences between military and civilian samples that may reduce disparities.