In addition to contributing to the overall Traumatic Brain Injury Model Systems (TBIMS) goal of understanding and improving longitudinal outcomes for individuals with traumatic brain injury (TBI), our TBI Model Systems has the following overall goals: (1) improving mental health monitoring and treatment for individuals with TBI; and (2) contributing knowledge regarding individual health perceptions that can reflect different social determinants of health and that can impact communication between people with TBI and their healthcare professionals, as well as overall health and participation outcomes. Our local research project is a study to track temporal patterns of everyday neurobehavioral symptoms (emotions, fatigue, cognitive challenges, substance use) that often develop into mental health conditions across the first year after TBI, and to determine patterns in these symptoms that predict a diagnosis of depression or anxiety at 1-year post-injury. Tracking is conducted via a mobile health platform developed specifically with and for persons with TBI, allowing for collection of data on emotional and behavioral symptoms in everyday life. Having a record of repeated assessments of emotional and behavioral functioning in their daily lives can help persons with TBI to track mental health and to seek help as needed. The use of mobile app technology, with ability to capture symptoms in real time rather than retrospectively, and in a person’s day-to-day environment could provide more accurate diagnosis based on frequency and duration of symptoms. To address our second goal, we will conduct a collaborative module project that will validate a measure of health perceptions for persons with TBI. This measure – the Multidimensional Health Perceptions Questionnaire (MHPQ) – was developed and validated in a general population, with both English and Spanish speakers, using patient-centered outcomes techniques. It captures several areas considered to be impo
rtant social determinants of health, including anticipated discrimination, spiritual health beliefs, beliefs about social and emotional well-being, trust in healthcare providers, health self-efficacy, and perceived health literacy. Our study aims to validate this measure for diverse persons with TBI and to conduct latent profile analysis to determine profiles of individuals with regard to these important health perceptions that may contribute to effectiveness of communications between persons with TBI and their healthcare providers. We will also explore the relationship between health perceptions and participation outcomes after TBI. Like our proposed project on mental health, this project has the potential to improve communication between persons with TBI and their healthcare providers. Providers could use these health perceptions profile as a basis for tailoring their recommendations and instructions to the individual health beliefs and perceptions of their patients and clients. Our TBIMS has a specific dissemination plan to present effective and usable information to our target audiences, including individuals with TBI, their care partners, and their healthcare professionals. Our expertise with dissemination to culturally diverse audiences, including Spanish speakers, will facilitate uptake and implementation across traditionally underserved racial and ethnic minority groups.