Brain Injury Outpatient Education and Care Navigation -Supplement

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PROJECT SUMMARY Celeste Garcia’s long-term goal is to become a research-scientist with a focus on implementation science directed to the needs of the Latinx/Hispanic community. She proposes two years of research and career development activities under mentoring of Drs. Nathalia Jimenez (PI for the parent grant and primary mentor for the diversity supplement), Ramirez, Ko and Zhou. Career development and training activities include comprehensive literature review, coursework, and mentoring directly relevant to the proposed research project. The primary research activity takes advantage of the multicenter design of the 1stBIEN parent grant. The diversity supplement proposes two complementary projects that explore inner and outer setting domains of the Consolidated Framework for Implementation Research (CFIR) related to the Latinx population. Study 1 assesses in real time implementation related domains of the 1stBIEN intervention at each of the participant sites. Study 2 evaluates outer context by pilot testing a population level measurement of socioeconomic disadvantage (The Area Deprivation Index ADI) as an independent predictor for post-TBI health care utilization and functional outcomes among Latinx/Hispanic children; and evaluate its effect on the response to the 1stBIEN intervention. This proposal uses mixed methods. Study 1 uses in depth interviews and thematic analysis grounded on CFIR to identify barriers and facilitators for program implementation of 1stBIEN core components and modifications in peripheral components to accommodate for institutional needs. Study 2 uses bivariate analysis examining the correlation coefficient between ADI and treatment adherence, and ADI and post-TBI function. To test if ADI modifies the intervention effects, subsequent linear regression models test the association between treatment adherence and post-TBI function and ADI, while controlling for intervention and baseline TBI severity. Findings from this study can facilitate prioritization of at-risk populations and strategies for institutional implementation of patient centric bilingual programs.