Brain Injury Outpatient Education and Care Navigation -Supplement

项目总结 塞莱斯特·加西亚的长期目标是成为一名专注于实现科学的研究科学家 针对拉丁裔/西班牙裔社区的需求。她建议进行两年的研究和职业生涯 在Nathalia Jimenez博士(家长补助金和主要导师的PI)指导下开展的发展活动 多样性补充)，Ramirez，Ko和周。职业发展和培训活动包括 与所提议的研究项目直接相关的全面的文献回顾、课程设计和指导。 主要的研究活动利用了1stBIEN家长资助的多中心设计。这个 多样性补充提出了两个相辅相成的项目，探索 与拉丁裔人口有关的执行研究综合框架。研究1 在每个参与者处实时评估1stBIEN干预的实施相关领域 网站。研究2通过试点测试社会经济的人口水平测量来评估外部环境 劣势(面积剥夺指数ADI)作为颅脑损伤后卫生保健利用的独立预测因子 和拉丁裔/西班牙裔儿童的功能结局；并评估其对应对 1stBIEN干预。这项提议使用了混合的方法。研究1采用深度访谈和专题研究 基于CFIR的分析，以确定1stBIEN核心计划实施的障碍和促进者 对外围部件进行组件和修改，以适应机构的需要。研究2用途 双因素分析检验ADI和治疗依从性之间的相关系数，ADI和 颅脑损伤后功能。为了检验ADI是否修改了干预效果，后续的线性回归模型测试了 治疗依从性与创伤性脑损伤后功能和ADI之间的关系，同时控制干预和 基线脑损伤严重程度。这项研究的结果有助于确定高危人群和策略的优先顺序 以病人为中心的双语计划的机构实施。

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.