Evaluation of Return to School Programs for Traumatic Brain Injury

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Abstract Although hospitals treat children and adolescents with TBI in their initial course of recovery, it is ultimately the school system that serves as the long-term provider of services to these students. The key components of effective Return to School (RTS) programs for students with TBI have been identified. These include (a) identification, screening, and assessment practices; (b) systematic communication between medical and educational systems; (c) tracking of child’s progress over time; and (d) professional development for school personnel. The Central Oregon TBI (COR-TBI) team model, operational in Oregon since 1994, incorporates all 4 components of an effective RTS program. The goal of this project is to compare the health, academic and social outcomes of children/youth with TBI who are served by the COR-TBI team model to outcomes of children/youth in a comparison site. We will use a mixed method quasi-experimental design using school districts in Washington and Ohio as comparison sites. The sample will be 600 children in Central Oregon school districts served by the COR-TBI model and 600 children in the comparison school districts. The comparison school districts do not have formalized return to school programs, and are well matched with the Oregon school districts on demographic factors. We will utilize propensity score estimates to match the COR- TBI and treatment-as-usual (TAU) groups and examine differences between the two sites in child health, academic and social outcomes. We will include a qualitative component to assess stakeholder perceptions of the model, including personal and contextual differences that may have subtle effects on child outcomes, and other unanticipated factors that may impact effective implementation of the model. At the conclusion of the project, we anticipate having evidence of efficacy of the model as well as a comprehensive understanding of the barriers and facilitators to implementation. The project’s translation plan, will be developed in Year 4 with input from our Advisory Board, stakeholders and CDC collaborators.