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Predictors of Intervention Adherence in Compensatory Cognitive Training for Veterans With a History of Mild Traumatic
Zanjbeel Mahmood1, Jillian M R Clark, Amy J Jak
1SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California (Ms Mahmood); Research Service (Ms Mahmood and Dr Twamley), Center of Excellence for Stress and Mental Health (Drs Clark, Jak and Twamley), and Psychology Service (Dr Jak), VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego (Drs Clark, Jak and Twamley); VA Portland Health Care System, Portland, Oregon (Drs Huckans, O'Neil, Roost, and Storzbach); Departments of Psychiatry (Drs Huckans, O'Neil, and Storzbach), Medical Informatics and Clinical Epidemiology (Dr O'Neil), and Neurology (Dr Storzbach), Oregon Health & Science University, Portland; VA Puget Sound Health Care System, Seattle, Washington (Drs Williams, Pagulayan and Turner); and Departments of Rehabilitation Medicine (Drs Williams and Turner) and Psychiatry and Behavioral Sciences (Dr Pagulayan), University of Washington School of Medicine, Seattle.
Objective:
The purpose of this study was to determine modifiable predictors of intervention adherence in a study of group-based Compensatory Cognitive Training (CCT) for Iraq/Afghanistan War veterans with a history of mild traumatic brain injury (mTBI).
Methods:
One hundred twenty-three veterans enrolled in a randomized controlled trial of a 10-week CCT intervention (54 assigned to CCT) and were evaluated at baseline, 5 weeks, 10 weeks, and 15 weeks. CCT adherence was determined by the number of CCT sessions attended, with more sessions indicative of greater adherence. Baseline demographic and clinical characteristics, and subjective and objective neuropsychological performance, were examined in relation to CCT session attendance.
Results:
Older age and worse attention performance at baseline were associated with higher CCT attendance rates.
Conclusions:
This study generates preliminary evidence for potential modifiable neuropsychological factors that may improve engagement in CCT interventions.
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