Community-Based Organizations and Development of Implementation Strategies for Brain Injury Screening Resulting from Intimate Partner Violence

项目摘要/摘要 在大脑从最初的创伤中恢复之前，经历了反复脑损伤(BIS)的人处于 神经功能障碍、抑郁、自杀和类阿尔茨海默氏症的高风险。经历过的女性 亲密伴侣暴力(IPV)是头部、颈部和面部受伤的高风险-可能导致 收购的BI。在IPV幸存者中，BI可能是由于隆起导致的创伤性脑损伤(TBI)， 猛击、摇晃头部或通过勒死。BI可以对IPV幸存者的健康产生长期影响- 生存和生活质量。在这一弱势人群中进行全面筛查并及时 神经康复干预(即，转诊和接受循证方法以减轻BI- 相关健康结果)有可能减轻IPV相关BI的影响并改善健康 结果。尽管IPV幸存者的BI风险很高，而且有循证方法可用 为了解决BI，在这一组女性中没有BI筛查的标准指南。长期目标是 促进对与IPV二级预防有关的实施战略的科学理解- 相关的商业智能将为未来的政策提供信息，以便及时进行筛查、转诊和神经康复，并最终 减少这一人群的神经损伤。这个项目的目标是检查如何筛选 而IPV相关的BI检测可以有效地融入到基于社区的工作流程中 以参与式方式为IPV幸存者提供服务的组织(CBO)。核心假设一直是 基于初步研究并假定CBO和利益相关者派生实施 战略可以改进采用、实施和维护及时筛查/检测和 转诊有BI风险的IPV幸存者。利用PRISM/RE-AIM框架和参与式办法 通过社区参与的传播和实施，将实现这些目标。目标1：评估 IPV幸存者脑损伤筛查干预措施的采用、实施和可持续性策略 在有和没有利益攸关方的社区组织制定了执行战略。目标2.确定覆盖范围 以及在服务于IPV幸存者的CBO中进行脑损伤筛查干预的有效性。探索性目标。 确定客户和CBO实施者对筛查干预和实施的看法 项目中使用的策略。预期的结果是增加目前对潜力的有限了解 实施战略，将IPV相关商业感染的常规筛查和转诊结合起来。这一结果是 预计将大大有助于充分整合常规筛查和 在服务于IPV幸存者的CBO中转介与IPV相关的BI。该项目还将允许确定 可用于将患有IPV相关BI的患者与证据联系起来的潜在筛查和转诊策略- 以减轻不良健康结果和确定实现二级预防的方法为基础的方法。

PROJECT SUMMARY/ABSTRACT People who experience repeated brain injuries (BIs) before the brain recovers from the initial trauma are at a high risk for neurological deficits, depression, suicide, and Alzheimer-like symptoms. Women who experience intimate partner violence (IPV) are at high risk for injuries to their head, neck and face – potentially resulting in an acquired BI. Among IPV survivors, BI can occur due to a traumatic brain injury (TBI) resulting from a bump, blow, or jolt to the head or through strangulation. BI can have long term consequences on IPV survivors' well- being and quality of life. Comprehensive screening among this vulnerable population and timely neurorehabilitation interventions (i.e., referral to, and receipt of, evidence-based approaches to mitigate BI- related health outcomes) have the potential to mitigate the impact of IPV-related BI and improve health outcomes. Despite the high risk of BI among IPV survivors and the availability of evidence-based approaches to address BI, there are no standard guidelines for BI screening in this group of women. The long-term goal is to advance scientific understanding of implementation strategies related to the secondary prevention of IPV- related BI that will inform future policies for timely screening, referral, and neurorehabilitation and ultimately reduce neurological damage among this population. The objective of this project is to examine how screening and detection of IPV-related BI can be effectively integrated into the workflow for community-based organizations (CBOs) serving IPV survivors using a participatory approach. The central hypothesis has been formulated based on preliminary studies and posits that CBO and stakeholder derived implementation strategies can improve the adoption, implementation, and maintenance of timely screening/detection and referral of IPV survivors at risk for a BI. Using the PRISM/RE-AIM framework and a participatory approach of community-engaged dissemination and implementation, these aims will be pursued. Aim 1: To evaluate adoption, implementation, and sustainability strategies of a brain injury screening intervention of IPV survivors at CBOs with and without stakeholder developed implementation strategies. Aim 2. To determine the reach and effectiveness of a brain injury screening intervention at CBOs serving survivors of IPV. Exploratory Aim. Determine client and CBO implementer's perception of the screening intervention and implementation strategies used in the project. The expected outcome is to increase currently limited knowledge of potential implementation strategies to integrate routine screening and referral for IPV-related BI. This outcome is expected to significantly contribute to the knowledge base needed to fully integrate the routine screening and referral of IPV-related BI in CBOs serving IPV survivors. The project will also allow for the identification of potential screening and referral strategies that can be used to connect patients with IPV-related BI to evidence- based approaches to mitigate poor health outcomes and identify methods to achieve secondary prevention.