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

亲密伴侣暴力造成的脑损伤筛查的社区组织和实施策略的制定

• 批准号: 10734518
• 负责人: Shireen Sheela Rajaram
• 金额: $ 51.18万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734518
• 关键词: Address; Adoption; Alzheimer' s Disease; Anoxia; Anxiety; Brain; Brain Injuries; Cessation of life; Client; Communities; Data; Detection; Development; Dissemination and Implementation; Distress; Effectiveness; Face; Fatigue; Future; Goals; Guidelines; Head; Headache; Health; Hypoxia; Injury; Intervention; Knowledge; Maintenance; Memory; Mental Depression; Methods; Neck; Nervous System Trauma; Neurologic Deficit; Outcome; Oxygen; Patients; Perception; Personal Satisfaction; Persons; Policies; Population; Practical Robust Implementation and Sustainability Model; Process; Provider; Public Health; Quality of life; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recovery; Reporting; Risk; Scientific Advances and Accomplishments; Screening Result; Secondary Prevention; Secondary to; Sleep; Suicide; Survivors; Symptoms; Testing; Trauma; Traumatic Brain Injury; Violence; Vulnerable Populations; Woman; Women' s Group; brain tissue; community organizations; contextual factors; evidence base; experience; health care settings; high risk; implementation process; implementation strategy; improved; intimate partner violence; knowledge base; neurological rehabilitation; novel; poor health outcome; routine practice; routine screening; screening; tv watching

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.

项目总结/摘要 在大脑从最初的创伤中恢复之前经历反复脑损伤（BI）的人处于 神经功能缺损、抑郁、自杀和阿尔茨海默病样症状的高风险。经历过 亲密伴侣暴力（IPV）是他们头部、颈部和面部受伤的高风险， 获得性BI。在IPV幸存者中，BI可能是由于撞击引起的创伤性脑损伤（TBI）而发生的， 打击，或震动头部或通过勒死。BI可能对IPV幸存者的健康产生长期影响- 存在和生活质量。对这一弱势群体进行全面筛查， 神经康复干预（即，转介和接受循证方法，以减轻BI- 相关健康结局）有可能减轻IPV相关BI的影响并改善健康状况 结果。尽管IPV幸存者中BI的风险很高，并且有循证方法可用， 为了解决BI，在这组妇女中没有BI筛查的标准指南。长期目标是 促进对IPV二级预防相关实施策略的科学理解， 相关的BI，将告知未来及时筛查、转诊和神经康复的政策，并最终 减少这一人群的神经损伤。这个项目的目的是研究如何筛选 和检测IPV相关的BI可以有效地集成到工作流程， 使用参与性方法为IPV幸存者提供服务的社区组织。核心假设是 根据初步研究制定，并假定CBO和利益相关者衍生实施 战略可以改善及时筛查/检测的采用、实施和维护， 转诊有BI风险的IPV幸存者。利用PRISM/RE-AIM框架和参与性方法， 通过社区参与的传播和执行，将努力实现这些目标。目标1：评价 IPV幸存者脑损伤筛查干预的采用、实施和可持续性策略 在有和没有利益相关者的社区组织制定了实施战略。目标2.为了确定 以及在为IPV幸存者服务的CBO中进行脑损伤筛查干预的有效性。探索目标。 确定客户和CBO实施者对筛选干预和实施的看法 项目中使用的策略。预期的结果是增加目前有限的知识， 实施策略，以整合IPV相关BI的常规筛查和转诊。这一结果 预计将大大有助于充分整合常规筛查所需的知识基础， 在为IPV幸存者服务的社区组织中转介IPV相关BI。该项目还将允许确定 可用于将IPV相关BI患者与证据联系起来的潜在筛查和转诊策略- 为减轻不良的健康结果，并确定实现二级预防的方法，