Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 29, 2019
Open Peer Review Period: Apr 1, 2019 - Apr 15, 2019
Date Accepted: Aug 31, 2019
(closed for review but you can still tweet)
Action Ethnography of Community Reintegration for Veterans and Military Service Members with TBI: A Mixed-Methods Study Protocol
ABSTRACT
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 (V/SM) populations. Little is known about how knowledge from civilian studies translates into Veterans’ experiences and needs. The United States Department of Veterans Affairs (VA) recognizes the distinctive healthcare needs of Post-911 V/SMs, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to V/SMs' homes and communities to facilitate CR.
Objective:
The current paper describes the rationale, design, and methods of the Action Ethnography of Community Reintegration for Veterans and Military Service Members with TBI protocol.
Methods:
This 5-year longitudinal ethnographic study used an applied Community-Based Participatory Research approach and mixed methods (interviews, questionnaires, observation). The sample included 30 V/SMs with TBI; 13 family caregivers; 11 CR specialists; 16 key stakeholders and 82 community events. Interviews and observations were coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis was used to highlight the complex social context of reintegration and to triangulate quantitative data.
Results:
Study enrollment and data collection were completed. Data analyses are underway.
Conclusions:
Study results provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate or severe TBI. V/SM and family voices and insights provide VA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of V/SMs and families. Results provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. Although the design lacks a comparison group for examining multiple locations across the United States, the longitudinal CBPR approach allows for capturing detailed experiences within the naturalistic context. CBPR afforded the opportunity for rigorous assessment of the social context of reintegration. Clinical Trial: NA
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Copyright
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