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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)

The final, peer-reviewed published version of this preprint can be found here:

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

Melillo C, Downs K, Dillahunt-Aspillaga C, Lind J, Besterman-Dahan K, Hahm B, Antinori N, Elnitsky C, Sander AM, Belanger HG, Toyinbo P, Powell-Cope G

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

JMIR Res Protoc 2019;8(11):e14170

DOI: 10.2196/14170

PMID: 31755868

PMCID: 6898887

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

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

  • Christine Melillo; 
  • Kiersten Downs; 
  • Christina Dillahunt-Aspillaga; 
  • Jason Lind; 
  • Karen Besterman-Dahan; 
  • Bridget Hahm; 
  • Nicole Antinori; 
  • Christine Elnitsky; 
  • Angelle M Sander; 
  • Heather G Belanger; 
  • Peter Toyinbo; 
  • Gail Powell-Cope

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.

Objective:

The goal of this study is to better understand the experiences of veterans with complicated mild, moderate, or severe TBI; their families; and CR workers as veterans and servicemembers transition to and sustain living in communities. This paper describes the rationale, design, and methods used to reach this goal.

Methods:

This five-year longitudinal mixed methods study uses both a community-engaged research (CEnR) approach and an ethnographic approach. The sample includes 30 veterans and service members with TBI, 13 family caregivers, 11 CR specialists, 16 key stakeholders, and 82 community events. Interviews and observations are coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis is used to highlight the complex social context of reintegration and to triangulate quantitative data. Egocentric (personal) social network analysis is used to examine the support system a veteran or service member has in place to facilitate reintegration.

Results:

Study enrollment and data collection are completed. Data analyses are underway.

Conclusions:

The results of this study may provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate, or severe TBI. Veteran, servicemember and family voices and insights provide VHA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of veterans, military service members, and families. The results of this study provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. The longitudinal ethnographic approach allows for capturing detailed experiences within the naturalistic context. CEnR allows collaborative assessment of the social context of reintegration with community members.

International Registered Report:

DERR1-10.2196/14170


 Citation

Please cite as:

Melillo C, Downs K, Dillahunt-Aspillaga C, Lind J, Besterman-Dahan K, Hahm B, Antinori N, Elnitsky C, Sander AM, Belanger HG, Toyinbo P, Powell-Cope G

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

JMIR Res Protoc 2019;8(11):e14170

DOI: 10.2196/14170

PMID: 31755868

PMCID: 6898887

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