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Race/Ethnicity and Community Participation Among Veterans and Service Members With Traumatic Brain Injury: A VA
Lillian Flores Stevens1, Jessica M Ketchum, Angelle M Sander
1Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, and Defense and Veterans Brain Injury Center (DVBIC), Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Dr Stevens); Research Department, Craig Hospital, Englewood, Colorado (Dr Ketchum); Research Services, James A. Haley Veterans Hospital, Tampa, Florida (Drs Ketchum and Dillahunt-Aspillaga); H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Harris Health System, and Brain Injury Research Center, TIRR Memorial Herman, Houston, Texas (Dr Sander); Baylor Research Institute at Baylor Institute for Rehabilitation, Dallas, Texas (Ms Callender); Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas (Dr Juengst); Rehabilitation and Mental Health Counseling Program, Department of Child and Family Studies, College of Family and Community Sciences, University of South Florida, Tampa (Dr Dillahunt-Aspillaga); Departments of Physical Medicine and Rehabilitation and Ophthalmology and Visual Sciences, University of Alabama at Birmingham (Dr Dreer); Minneapolis Veterans Affairs Health Care System, and Department of Psychiatry, University of Minnesota-Twin Cities, Minneapolis (Dr Finn); Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond (Dr Gary); Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York City, New York (Drs Kajankova and Kolakowsky-Hayner); Kessler Foundation, East Hanover, New Jersey (Dr Lequerica); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark (Dr Lequerica); and Moss Rehabilitation Research Institute, Elkins, Pennsylvania (Dr Rabinowitz).
Hispanic veterans with traumatic brain injury (TBI) showed higher community participation in the Out & About domain compared to White veterans. These findings suggest military samples may have fewer racial disparities in TBI participation outcomes.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Health Services Research
Background:
- Traumatic brain injury (TBI) significantly impacts community participation.
- Racial and ethnic disparities in healthcare outcomes are well-documented.
- Understanding these disparities in veterans with TBI is crucial for targeted interventions.
Purpose of the Study:
- To investigate racial and ethnic differences in community participation among US military veterans and active duty service members with TBI.
- To analyze participation across different domains: Out & About, Productivity, and Social Relations.
Main Methods:
- A cross-sectional analysis was conducted on a prospective observational cohort study.
- Data from 342 community-dwelling adults with TBI were collected from five Department of Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs).
- Community participation was assessed at 1-year post-injury using the Participation Assessment with Recombined Tools-Objective (PART-O).
Main Results:
- Initially, significant differences were found in Productivity and Out & About domains among racial/ethnic groups.
- Non-Hispanic Black participants scored higher in Productivity than non-Hispanic White participants.
- Hispanic participants scored higher in Out & About than non-Hispanic White participants, and this remained significant after controlling for covariates.
Conclusions:
- Racial and ethnic differences in community participation among veterans with TBI may differ from those observed in civilian healthcare settings.
- The military and veteran population characteristics might mitigate racial/ethnic disparities in TBI participation outcomes.
- Further research is needed to explore factors contributing to these observed differences.
