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PPO 08-399 – HSR&D Study

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PPO 08-399
Treatment of OEF/OIF Veteran Neuropsychiatric Outcomes Following TBI
Armando J. Rotondi PhD
VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA
Pittsburgh, PA
Funding Period: August 2009 - March 2011

BACKGROUND/RATIONALE:
Mild Traumatic brain injury (mTBI) may be associated with changes in an individual's psychosocial functioning. These changes have stronger effects than physical consequences on family functioning, interpersonal relationships, and reintegration back into society. However, there is a dearth of treatments to manage these neuropsychiatric consequences of TBI. The intervention will provide family psychoeducation (FPE), an evidence based treatment to address Veteran and family stresses and, in particular, the neuropsychiatric behavioral consequences of mTBI employing our web-enhanced delivery methods.

OBJECTIVE(S):
To develop and test the content, feasibility and acceptability of a web-based family-centered psychoeducational intervention for OEF/OIF Veterans with mTBI and their families.

METHODS:
The feasibility of the website is being tested via a random controlled trial of Veterans with mTBI assigned in a 2 (TAU, n=10):3 (intervention, n=15) ratio. This split will provide more information about the intervention in preference to TAU, which is appropriate in a feasibility study. Analyses will assess group differences across time and interaction of group and time comparisons.

FINDINGS/RESULTS:
A highly usable website, with the following content was developed: 3 group treatment forums (Veterans only, family only, both); a library of educational and self-help materials; a function to ask questions; and a library of previously asked questions. Experts in Information Sciences and cognitive design created the initial website. Usability and heuristic evaluations were used to refine the website. We have screened over 100 Veterans for eligibility, sent recruitment letters to 62, and received contact from 23. Twelve subjects have been recruited (7 Veterans and 3 family members), all of whom have completed baseline and pre-test assessments. Identifying eligible participants has been complicated due to a need to use difficult to obtain subjective criteria in addition to clinical/medical record data. We have recently identified a new source for participants (the University of Pittsburgh) and anticipate being able to end recruitment and baseline/pre-test assessments in 9 weeks. Final post-test assessments should be completed 15 weeks after that. This should provide the complete data that was proposed.

IMPACT:
By developing and testing an on-line treatment for OEF/OIF Veterans with mTBI, and their families the VA may better treat the neuropsychiatric consequences of TBI, and improve Veteran and family wellbeing.

PUBLICATIONS:
None at this time.


DRA: Acute and Combat-Related Injury, Brain and Spinal Cord Injuries and Disorders, Mental, Cognitive and Behavioral Disorders
DRE: Treatment - Observational
Keywords: Behavioral Therapy, Clinical Diagnosis and Screening, TBI
MeSH Terms: none

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