Race/Ethnicity and Community Participation among Veterans and Service Members with Traumatic Brain Injury: A VA Traumatic Brain Injury Model Systems Study

Lillian Flores Stevens, Jessica M. Ketchum, Angelle M. Sander, Librada Callender, Christina Dillahunt-Aspillaga, Laura E. Dreer, Jacob A. Finn, Kelli W. Gary, Kristin M. Graham, Shannon B. Juengst, Maria Kajankova, Stephanie Kolakowsky-Hayner, Anthony H. Lequerica, Amanda R. Rabinowitz

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)408-417
Number of pages10
JournalJournal of Head Trauma Rehabilitation
Issue number6
StatePublished - 2021


  • community participation
  • military personnel
  • racial disparities
  • traumatic brain injuries
  • veterans

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology


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