Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial

Abstract

Objective: Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans’ In-home Programme (VIP), delivered in veterans’ homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning.

Setting: Interviews and intervention sessions were conducted in homes or by telephone.

Participants: Eighty-one veterans with TBI at a VA polytrauma programme and a key family member.

Design: This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview.

Main measures: VIP’s efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans’ self-identified problems and self-rated functional competence.

Results: At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP’s acceptability was high.

Conclusion: A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.

Keywords:

• Community reintegration
• family
• in-home service
• rehabilitation
• traumatic brain injury
• veterans

Acknowledgements

The research team gratefully acknowledges the veterans with TBI and their family members who gave of themselves and their time to take part in this study.

Declaration of interest

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the National institutes of Health, the position or policy of the Department of Veterans Affairs, or the United States government.