Development and Pilot Testing of eHealth Problem-Solving Training (ePST) for Adults with Traumatic Brain Injury
Abstract
Who Will This Help and How It Will Help Them? Traumatic brain injury (TBI) is a condition of growing concern in the United States, particularly among Veterans/Service members. TBI often leads to physical, cognitive, emotional, and behavioral symptoms that can affect reintegration into civilian life, social functioning and health, and quality of life. Cognitive and emotional changes after TBI are especially concerning, as they contribute to high rates of suicide, substance abuse, and social problems among Service Members with this condition. Therefore, treating or preventing these symptoms is critically important and could save lives. Problem-Solving Training (PST) teaches a standard, step-by-step, problem-solving strategy A=Assess; B=Brainstorm; C=Consider and Choose; D=Develop and Do; E=Evaluate; F=Flex that can be used to solve problems or achieve goals. This strategy could be applied to whatever everyday problems and goals a person chose, making it flexible and adaptable to every individual. By supporting goal achievement and a person’s ability to solve daily problems, we could prevent and improve function, health, and overall quality of life of Veterans/Service Members and civilians with TBI and their care partners. Objectives and Rationale for the Proposed Project: Though PST is already delivered remotely over the phone or video call, it still requires time from a trained therapist and coordinating times for a therapist and person with TBI to meet. With more people having access to and comfort using mobile devices, more people could benefit from PST if we could adapt it to an electronic format. Therefore, to provide a more widely available, accessible, and effective support for persons living with the chronic psychological health consequences of TBI, we propose to co-design, co-develop, and pilot test an electronic and mobile version of PST (ePST) for adults with TBI in collaboration with our Community Advisory Board. CBPR Approach and Implementation: We have established a Community Advisory Board (CAB) made up of diverse persons with lived TBI experience (survivors and care partners), community partners, and subject matter experts. We will engage with our Community Advisory Board through quarterly meetings, large group email communications, and smaller group (e.g., workgroup) emails and meetings. To foster equitable participation and collaborative decision-making, we established a plan following the Multi-Stakeholder Research Journey Engagement Roadmap. Our CAB will co-design and co-develop our ePST intervention, inform pilot testing and iterative adaptations, and actively participate in disseminating and implementing ePST at the end of the project. Applicability and How This Project addresses the FY22 TBIPHRP PCRA Focus Areas: Our project directly addresses the Psychological Health and Traumatic Brain Injury Research program (PH/TBIRP) mission to optimize prevention, assessment, and treatment of psychological health issues and TBI in two focus areas: treat psychological health conditions via evidence-based interventions and prevent psychological health conditions by developing and optimizing interventions addressing upstream factors (i.e., problem-solving). Potential Clinical Applications, Benefits, and Risks: ePST will be a low-risk, high-reward, cost-effective, time-efficient, and Service Member-informed intervention for managing and improving psychological health symptoms common after TBI. The telehealth platform will maximize efficiency and capacity to include a broader and more geographically remote population. Projected Timeline to Achieve a Patient-Related Outcome: We propose to complete this project in 3 years. The first 18 months will be dedicated to designing and developing ePST, in partnership with our CAB. During months 18-30, we will pilot test ePST (vs traditional PST and a Hybrid ePST/PST) among 40 persons with TBI, during which time we will also determine changes t
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310567
Entities
People
- Shannon Juengst
Organizations
- TIRR Memorial Hermann
- United States Army