Goal intention reminding in traumatic brain injury: A feasibility study using implementation intentions and text messaging

ABSTRACT

Objective: To examine feasibility of participant-created implementation intentions, delivered as text message reminders, to enhance goal-related activity in persons with chronic, moderate/severe traumatic brain injury (TBI).

Design: Pilot randomized controlled trial on effects of 8 weeks receiving goal-related implementation intentions (GI) compared to control condition, educational review regarding goals (GR).

Participants: Eight persons with moderate/severe TBI nearing discharge from intensive outpatient brain injury treatment.

Measures: Neuropsychological tests to characterize cognitive status; Participation with Recombined Tools-Objective (PART-O) assessing community activity, social relations and productivity; Brief Symptom Inventory-18 (BSI-18) assessing depression, anxiety and overall distress; Goal Attainment Scales (GAS). PART-O, BSI-18 and GAS were completed at baseline and 8 weeks; significant others provided ratings on PART-O and GAS.

Results: Participants replied to SMS messages at high rates. Statistically significant group × time interactions with medium-to-large effect sizes favouring the GI group were observed on PART-O community activity and social relations. Neither BSI-18 nor GAS revealed differences or trends by group. Qualitative results suggested overall acceptance and success of SMS reminders.

Conclusions: Given positive preliminary findings, implementation intentions delivered by text holds promise as a simple, low-cost intervention to help people with moderate/severe TBI to implement goal-relevant behaviours.

KEYWORDS:

• Brain injuries
• goal management training
• implementation intentions
• rehabilitation technology

Acknowledgements

We thank the clinicians of the Drucker Brain Injury Center, MossRehab Hospital, for referring participants and providing valuable clinical information. We are indebted to Kelly Bognar for performing neuropsychological testing, managing data and assisting with recruitment and to Tincy Philip for assisting with SMS message management.

Declaration of interest

This research was funded by a grant from the Pennsylvania Department of Health (SAP #4100054839) to the first author. The authors alone are responsible for the content and writing of the paper.