TY - JOUR
T1 - Societal Participation of People With Traumatic Brain Injury Before and During the COVID-19 Pandemic
T2 - A NIDILRR Traumatic Brain Injury Model Systems Study
AU - Venkatesan, Umesh M.
AU - Adams, Leah M.
AU - Rabinowitz, Amanda R.
AU - Agtarap, Stephanie
AU - Bombardier, Charles H.
AU - Bushnik, Tamara
AU - Chiaravalloti, Nancy D.
AU - Juengst, Shannon B.
AU - Katta-Charles, Sheryl
AU - Perrin, Paul B.
AU - Pinto, Shanti M.
AU - Weintraub, Alan H.
AU - Whiteneck, Gale G.
AU - Hammond, Flora M.
N1 - Publisher Copyright:
© 2023 American Congress of Rehabilitation Medicine
PY - 2023/7
Y1 - 2023/7
N2 - Objective: To examine the effect of the COVID-19 pandemic on societal participation in people with moderate-to-severe traumatic brain injury (TBI). Design: Cross-sectional retrospective cohort. Setting: National TBI Model Systems centers, United States. Participants: TBI Model Systems enrollees (N=7003), ages 16 and older and 1-30 years postinjury, interviewed either prepandemic (PP) or during the pandemic (DP). The sample was primarily male (72.4%) and White (69.5%), with motor vehicle collisions as the most common cause of injury (55.1%). Interventions: Not applicable. Main Outcome Measure: The 3 subscales of the Participation Assessment with Recombined Tools-Objective: Out and About (community involvement), Productivity, and Social Relations. Results: Out and About, but not Productivity or Social Relations, scores were appreciably lower among DP participants compared to PP participants (medium effect). Demographic and clinical characteristics showed similar patterns of association with participation domains across PP and DP. When their unique contributions were examined in regression models, age, self-identified race, education level, employment status, marital status, income level, disability severity, and life satisfaction were variably predictive of participation domains, though most effects were small or medium in size. Depression and anxiety symptom severities each showed small zero-order correlations with participation domains across PP and DP but had negligible effects in regression analyses. Conclusions: Consistent with the effect of COVID-19 on participation levels in the general population, people with TBI reported less community involvement during the pandemic, potentially compounding existing postinjury challenges to societal integration. The pandemic does not appear to have altered patterns of association between demographic/clinical characteristics and participation. Assessing and addressing barriers to community involvement should be a priority for TBI treatment providers. Longitudinal studies of TBI that consider pandemic-related effects on participation and other societally linked outcomes will help to elucidate the potential longer-term effect the pandemic has on behavioral health in this population.
AB - Objective: To examine the effect of the COVID-19 pandemic on societal participation in people with moderate-to-severe traumatic brain injury (TBI). Design: Cross-sectional retrospective cohort. Setting: National TBI Model Systems centers, United States. Participants: TBI Model Systems enrollees (N=7003), ages 16 and older and 1-30 years postinjury, interviewed either prepandemic (PP) or during the pandemic (DP). The sample was primarily male (72.4%) and White (69.5%), with motor vehicle collisions as the most common cause of injury (55.1%). Interventions: Not applicable. Main Outcome Measure: The 3 subscales of the Participation Assessment with Recombined Tools-Objective: Out and About (community involvement), Productivity, and Social Relations. Results: Out and About, but not Productivity or Social Relations, scores were appreciably lower among DP participants compared to PP participants (medium effect). Demographic and clinical characteristics showed similar patterns of association with participation domains across PP and DP. When their unique contributions were examined in regression models, age, self-identified race, education level, employment status, marital status, income level, disability severity, and life satisfaction were variably predictive of participation domains, though most effects were small or medium in size. Depression and anxiety symptom severities each showed small zero-order correlations with participation domains across PP and DP but had negligible effects in regression analyses. Conclusions: Consistent with the effect of COVID-19 on participation levels in the general population, people with TBI reported less community involvement during the pandemic, potentially compounding existing postinjury challenges to societal integration. The pandemic does not appear to have altered patterns of association between demographic/clinical characteristics and participation. Assessing and addressing barriers to community involvement should be a priority for TBI treatment providers. Longitudinal studies of TBI that consider pandemic-related effects on participation and other societally linked outcomes will help to elucidate the potential longer-term effect the pandemic has on behavioral health in this population.
KW - Anxiety
KW - Brain injuries, traumatic
KW - COVID-19 pandemic
KW - Community integration
KW - Depression
KW - Personal satisfaction
KW - Quality of life
KW - Rehabilitation
KW - Social relationships
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U2 - 10.1016/j.apmr.2023.01.009
DO - 10.1016/j.apmr.2023.01.009
M3 - Article
C2 - 36736808
AN - SCOPUS:85152122892
SN - 0003-9993
VL - 104
SP - 1041
EP - 1053
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 7
ER -