Understanding Service Needs of Persons with Brain Injury

Research Objectives: To identify Department of Defense-specific facilitators and barriers to delivering healthcare services post military traumatic brain injury and highlight recommendations to improve systems of care.

Design: A qualitative descriptive study design will be used.

Setting: Administrators and policymakers from the Department of Defense.

Participants: Key informant stakeholder interviews with high-level policy and administrative staff from within the DoD. Participants had specialized knowledge due to their unique positions and responsibilities. One-hour Interviews were conducted either virtually or in-person.

Interventions: N/A

Main Outcome Measures: Facilitators and barriers to delivering healthcare services post military traumatic brain injury.

Results: The DoD administrators focused on a cultural shift in TBI care since the implementation of the Warfighter Brain Health Initiative to improve brain health, including the long-term outcomes of service members post-TBI. Specifically, this shift from a deployment and injury-based model of care to a long-term model of care that includes monitoring through baseline and intermittent assessments includes both organizational improvements (e.g., education and training to improve screening practices), as well as patient-specific improvements (e.g., promotion of health literacy and beliefs about TBI). Administrators also identified a lack of funding and personnel as key challenges to implementation, as well as collaborative challenges among the VA and DoD due to siloed funding and leadership turnover within these organizations.

Conclusions: Early implementation of the Warfighter Brain Health Policy to improve brain health, including the long-term outcomes of Service Members and Veterans with TBI, has created a cultural shift in how TBI is perceived, prevented, identified, and monitored from the healthcare system viewpoint. Early implementation efforts highlight the need for strengthening of partnerships between DoD and VA and continued education and training at both the organizational and patient (health belief) levels.

Author(s) Disclosures: The views expressed in this abstract are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. For more information, please contact dha.TBICOEinfo@health.mil. UNCLASSIFIED