Examination of Health Areas for Change Among Community Dwelling Survivors of a Moderate-Severe Traumatic Brain Injury: A Need for Patient-Centered, Comprehensive Health and Wellness Initiatives

Abstract

<h3>Research Objectives</h3> To understand health areas for potential change among community-dwelling survivors of a moderate/severe traumatic brain injury (TBI). <h3>Design</h3> Cross-sectional, descriptive. <h3>Setting</h3> Community-based. <h3>Participants</h3> As part of an ongoing study, N = 28 community dwelling survivors of a moderate/severe TBI who were enrolled in the UAB TBI Model System longitudinal study and at least one year up to 5-years post-injury (M age = 40.59; SD=18.61) served as participants to date. <h3>Interventions</h3> Telehealth-based, health and wellness intervention. <h3>Main Outcome Measures</h3> A checklist of comprehensive health areas developed for the study. Prior to the beginning of the intervention, participants are asked to rate their preferences among twelve health areas that they might be interested in improving and to rank-order their health goal preferences they wanted to work on for the intervention in order of importance (1st, 2nd, etc.). <h3>Results</h3> All health areas were endorsed as goals of interest for changing. The top five health goals included: physical activity and exercise (92.9%), mental activity (85.7%), nutrition and dietary intake (78.6%), health knowledge and information (78.6%), and stress management (71.4%) which tied with mental health (71.4%). To a somewhat lesser extent, social relationships (64.3%), spirituality/purpose and meaning (50.0%), sleep (35.7%), leisure (28.6%), alcohol use (17.9%), and tobacco use (17.9%) were also of interest. Every health goal received at least one ranking of being a number one goal to address as part of a health intervention. <h3>Conclusions</h3> The findings demonstrate a range of health goals of interest to community dwelling survivors of a moderate/severe TBI 1-year or greater post-injury. While traditional rehabilitation programs typically focus more on mental health, physical, functioning, and cognitive issues, the current findings warrant the need for expanding services to address additional areas (e.g., spirituality/purpose and meaning, leisure, social relationships). Given the range of health goals that individuals ranked as first choice preferences, the findings highlight the need for health and wellness programs that can be individually tailored. Consistent with Healthy People 2030, a more expansive conceptualization of health may help modify preventable secondary health conditions and continue to optimizing recovery. <h3>Author(s) Disclosures</h3> None.