Enhancing Veteran Community Reintegration Research (ENCORE): Protocol for a Mixed Methods and Stakeholder Engagement Project.

Background: Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service.

Objective: Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration's Health Service Research and Development Service.

Return to School Outcomes among Adults with TBI One Year After Rehabilitation Discharge: A TBIMS Study.

Objective: To examine return to school outcomes 1 year after traumatic brain injury (TBI) rehabilitation discharge.

Design: Longitudinal observational study using Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) data at 1-year post-TBI.

Setting: Inpatient rehabilitation centers using follow-up telephone calls.

Development of the traumatic brain injury Rehabilitation Needs Survey: a Veterans Affairs TBI Model Systems study.

Purpose: To describe the development of the Rehabilitation Needs Survey (RNS) for persons in the chronic phase of traumatic brain injury (TBI) recovery.

Materials And Methods: RNS items were generated following a literature review (January - March 2015) on the topic of rehabilitation needs and revised consensus from an expert panel of TBI clinicians and researchers. The RNS was added to the VA TBI Model Systems longitudinal study; data collection occurred between 2015-2019.

Race/Ethnicity and Community Participation Among Veterans and Service Members With Traumatic Brain Injury: A VA Traumatic Brain Injury Model Systems Study.

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.

Demographic and Mental Health Predictors of Arrests Up to 10 Years Post-Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study.

Objective: Examine rates and predictors of arrests in Veterans and Service Members (V/SM) who received inpatient rehabilitation for traumatic brain injury (TBI).

Setting: Veterans Administration (VA) Polytrauma Rehabilitation Centers.

Participants: A total of 948 V/SM drawn from the VA TBI Model Systems cohort with arrest data up to 10 years post-TBI.

Evolution of Irritability, Anger, and Aggression after Traumatic Brain Injury: Identifying and Predicting Subgroups.

The current prospective, multi-center, longitudinal cohort study examined how veterans/service members (V/SM) changed in their irritability, anger, and aggression (IAA) scores from admission to discharge in post-acute rehabilitation settings. The goals were to identify trajectory subgroups, and explore if there were different predictors of the subgroups. V/SM ( = 346) from five Veterans Affairs TBI Model Systems Polytrauma Rehabilitation Centers participated.

Rehabilitation Needs at 5 Years Post-Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: Describe rehabilitation needs and factors associated with unmet needs at 5 years post-traumatic brain injury (TBI).

Setting: Five Veterans Affairs (VA) polytrauma rehabilitation centers (PRCs).

Participants: VA TBI Model Systems participants (N = 283; 96% male, 75%, 57% severe TBI).

Unmet Rehabilitation Needs Indirectly Influence Life Satisfaction 5 Years After Traumatic Brain Injury: A Veterans Affairs TBI Model Systems Study.

Objective: To describe the association between unmet rehabilitation needs and life satisfaction 5 years after traumatic brain injury (TBI).

Design: Prospective observational cohort.

Setting: Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers.

Provision of resource facilitation services for individuals with acquired brain injury across the United States: results of a 2018 resource facilitator provider survey.

Objective: Resource Facilitation is a lesser-known service line within the field of brain injury rehabilitation and has been described as similar to case management, care coordination, and neuronavigation. The purpose of this project was to evaluate current Resource Facilitation programs and provide a comprehensive summary of program characteristics to work toward a common definition of Resource Facilitation services and inform future program development and evaluation frameworks.

Materials And Methods: An online survey was sent to all known Resource Facilitation programs in the US (N = 70).

Action Ethnography of Community Reintegration for Veterans and Military Service Members With Traumatic Brain Injury: Protocol for a Mixed Methods Study.

Background: Numerous studies of community reintegration (CR) in traumatic brain injury (TBI) have been conducted in civilian populations, but research is limited in veteran and military service member populations. Little is known about how knowledge from civilian studies translates into veterans' experiences and needs. The US Department of Veterans Health Administration (VHA) recognizes the distinctive health care needs of post-9/11 veteran and military service members, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to veteran and military service members' homes and communities to facilitate CR.

Vocational Rehabilitation in the Veterans Health Administration Polytrauma System of Care: Current Practices, Unique Challenges, and Future Directions.

Objective/purpose: Veterans and service members (V/SMs) with traumatic brain injury (TBI) and comorbid conditions are treated in the Veterans Health Administration (VHA) Polytrauma System of Care (PSC). These V/SMs comprise a unique population with distinct needs for restoring community reintegration, including participation in meaningful employment. Low employment rates after TBI vary and are influenced by many factors.

Employment Stability in the First 5 Years After Moderate-to-Severe Traumatic Brain Injury.

Objective: To characterize employment stability and identify predictive factors of employment stability in working-age individuals after moderate-to-severe traumatic brain injury (TBI) that may be clinically addressed.

Design: Longitudinal observational study of an inception cohort from the Traumatic Brain Injury Model Systems National Database (TBIMS-NDB) using data at years 1, 2, and 5 post-TBI.

Setting: Inpatient rehabilitation centers with telephone follow-up.

Community Reintegration, Participation, and Employment Issues in Veterans and Service Members With Traumatic Brain Injury.

Traumatic brain injury (TBI) has been called the signature injury of the post-9/11 wars in Iraq, Afghanistan, and neighboring countries. Although similarities exist between veterans and service members with TBI, levels of severity and different constellations of coexisting comorbid conditions affect them differently. These conditions affect physical, cognitive, and emotional function, which in turn can complicate community reintegration (CR), or the ability to return to family, vocational, and community life.

Comparison of the VA and NIDILRR TBI Model System Cohorts.

Objective: Within the same time frame, compare the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and VA Traumatic Brain Injury Model System (TBIMS) data sets to inform future research and generalizability of findings across cohorts.

Setting: Inpatient comprehensive interdisciplinary rehabilitation facilities.

Participants: Civilians, Veterans, and active duty service members in the VA (n = 550) and NIDILRR civilian settings (n = 5270) who were enrolled in TBIMS between August 2009 and July 2015.

Traumatic Brain Injury Severity, Comorbidity, Social Support, Family Functioning, and Community Reintegration Among Veterans of the Afghanistan and Iraq Wars.

Objective: To examine the association between traumatic brain injury (TBI) severity; social, family, and community reintegration outcomes; and return to work status among post-9/11 veterans in Department of Veterans Affairs (VA) care.

Design: Retrospective observational cohort study.

Setting: Mail/online survey fielded to a national sample of veterans.

Employment Stability in Veterans and Service Members With Traumatic Brain Injury: A Veterans Administration Traumatic Brain Injury Model Systems Study.

Objective: To examine incidence and predictors of employment stability in veterans and military service members with traumatic brain injury (TBI) who return to work.

Design: Prospective observational cohort study.

Setting: Four rehabilitation centers.

Supervision Needs Following Veteran and Service Member Moderate to Severe Traumatic Brain Injury: A VA TBI Model Systems Study.

Objective: To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population.

Setting: Five VA Polytrauma Rehabilitation Centers.

Participants: A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program.

Predictors of Employment Outcomes in Veterans With Traumatic Brain Injury: A VA Traumatic Brain Injury Model Systems Study.

Objectives: To examine the length of time to return to work (RTW) among service members and veterans (SM/V) with traumatic brain injury (TBI) and to identify variables predictive of RTW.

Setting: Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRC).

Participants: SM/V enrolled in the VA PRC Traumatic Brain Injury Model Systems database who were of 18 to 60 years of age and admitted with the diagnosis of TBI.

Allostatic Perspectives in Women Veterans With a History of Childhood Sexual Assault.

Background: Women veterans have increased reports of sexual victimization compared to women in general, including childhood sexual assault (CSA) before military service, increasing the risk of military sexual trauma. Findings from recent studies reveal negative health effects following a history of CSA. There is a strong relationship between CSA and revictimization in civilian and military life, which may contribute to allostatic load.

Exploring Vocational Evaluation Practices following Traumatic Brain Injury.

Background: Individuals with traumatic brain injury (TBI) face many challenges when attempting to return to work (RTW). Vocational evaluation (VE) is a systematic process that involves assessment and appraisal of an individual's current work-related characteristics and abilities.

Objective: The aims of this study are to (1) examine demographic and employment characteristics of vocational rehabilitation providers (VRPs), (2) identify the specific evaluation methods that are used in the VE of individuals with TBI, and (3) examine the differences in assessment method practices based upon evaluator assessment preferences.

Decreased Movement Path Tortuosity Is Associated With Improved Functional Status in Patients With Traumatic Brain Injury.

Objective: To determine if movement path tortuosity in everyday ambulation decreases in Veterans being treated in a residential setting for traumatic brain injury. Elevated path tortuosity is observed in assisted living facility residents with cognitive impairment and at risk for falls, and tortuosity may decrease over the course of cognitive rehabilitation received by the Veterans. If observed, decreased tortuosity may be linked to improved clinical outcomes.

Predictors of behavioural health service use and associated expenditures: Individuals with TBI in Pinellas County.

Objective: Traumatic brain injury (TBI) is a major public health concern. Such injuries often result in dramatic changes in the individual's life-course due to the associated complex co-morbidities. Limited research exists on the use and expenditures incurred for behavioural healthcare services post-TBI.

Using information from the electronic health record to improve measurement of unemployment in service members and veterans with mTBI and post-deployment stress.

Objective: The purpose of this pilot study is 1) to develop an annotation schema and a training set of annotated notes to support the future development of a natural language processing (NLP) system to automatically extract employment information, and 2) to determine if information about employment status, goals and work-related challenges reported by service members and Veterans with mild traumatic brain injury (mTBI) and post-deployment stress can be identified in the Electronic Health Record (EHR).

Design: Retrospective cohort study using data from selected progress notes stored in the EHR.

Setting: Post-deployment Rehabilitation and Evaluation Program (PREP), an in-patient rehabilitation program for Veterans with TBI at the James A.