SELF-MANAGEMENT THROUGH AN ELECTRONIC FRAMEWORK AFTER TRAUMATIC BRAIN INJURY (SELF-TBI) - Self-management through an ELectronic Framework after Traumatic Brain Injury (SELF-TBI) Traumatic brain injury (TBI) results in impairments in physical, sensory, cognitive, emotional, and behavioral functioning that are often chronic and associated with decreased physical and mental health and functioning. Many people with TBI have multiple chronic conditions or life circumstances to self-manage. Providing education to people about their specific conditions, including TBI, is not adequate to maintain health and function. While education is an important component, management of chronic health conditions requires self-management skills, including symptom monitoring, problem-solving, decision making, resource utilization, forming of healthcare partnerships, and taking action. Unfortunately, the skills necessary to actively engage in self-management can be particularly challenging due to TBI-related impairments in cognitive and behavioral function. For this reason, individuals with TBI often require assistance from a care partner in order to self-manage their health and functioning. Care partners may not be equipped to provide this support without training and ongoing support. Training of individuals with TBI and their care partners in self-managing health and function has the potential to prevent health deterioration and improve functioning across the lifespan. Self-management has been shown to be effective for improving aspects of health and function in individuals with chronic conditions that have symptom overlap with TBI, including mental health disorders, chronic pain, and stroke. However, there is no existing self-management training program that is implemented as a standard of care for individuals with TBI in the acute to post-acute phase of recovery. Our proposed project is aimed at developing, testing, and effectively disseminating an electronic self-management tool (SELF-TBI) for individuals with traumatic brain injury (TBI). The contents of the tool are guided by the evidence base on the effectiveness of self-management training for improving health and function in individuals with chronic health conditions. The overarching goal of the project is to empower individuals with TBI to engage in self-management activities to maintain physical and mental health across their lifespans. The tool will include training in self-monitoring of symptoms, actions to take when symptoms emerge and persist, and systematic problem-solving of health-related issues. Input from stakeholders will guide development of the tool, and consultation with a patient-provider communication and education engagement expert will ensure usability and satisfaction with the resulting tool. The tool will be tested for usability and satisfaction in a sample of 10 individuals with TBI and their care partners, including those from underserved groups, and feedback will be implemented before Beta-testing. Beta-testing will be conducted in a group of 200 individuals with TBI representing a range of post-injury time points, and recruiting from sources that include underserved groups. The resulting electronic package of education, self-monitoring with prompts to action, and problem-solving will be accessible to individuals with TBI and their care partners through planned partnerships with advocacy organizations, and will also be disseminated to clinicians who treat people with TBI and can refer them to the SELF-TBI tool. The SELF-TBI tool has the potential to increase access to effective training in self-management of health by individuals with TBI, both those who are independent and those who require assistance of a care partner to self-manage.
