The New York Traumatic Brain Injury Model System (NY-TBIMS) at Mount Sinai Hospital (MSH) provides comprehensive interdisciplinary services for individuals with traumatic brain injury (TBI) across the continuum from injury to community integration. We proudly serve one of the most diverse populations in the world, spanning all 5 boroughs of New York City and surrounding regions. NIDILRR's investment in TBI research at Mount Sinai over 35 years ago laid the foundation for a center of excellence in TBI research, the Brain Injury Research Center of Mount Sinai (BIRC-MS): home to the NY-TBIMS since 1987. During the next 5 year funding cycle, we will enroll a minimum of 35 individuals per year, contributing substantially to the diversity and representativeness of the TBIMS National Database (NDB). We will collaborate with other centers to conduct high impact research, lead and mentor collaborative projects to strengthen a diverse rehabilitation workforce, and leverage TBIMS infrastructure for inter-agency funding initiatives that amplify its breadth and impact. The NY-TBIMS benefits from the collaboration of individuals living with TBI and other stakeholders in every component of our work; our research reflects the priorities of those we serve. Our goal is to be a model of care delivery for persons with TBI throughout the world: providing individualized care, for as long as care is needed.
Our site-specific research project, Community-based Implementation of an Emotion Regulation Intervention for Individuals with TBI, will build upon NIDILRR's previous investments in developing and establishing the efficacy of an accessible internet-based group treatment for post-TBI emotional dysregulation (Online EmReg). Per NIDILRR's stages-of-research framework, we will use implementation science methods to compare two implementation strategies designed to train community-based clinicians to provide the Online EmReg intervention to individuals with TBI. Embedded in this trial is an investigation of the effectiveness of Online EmReg when delivered outside the context of a clinical trial. This study will inform best practices for translating evidence-based rehabilitation interventions into the community, thereby improving access to specialized care for individuals with TBI. Our multi-center module project, Associations of Early Life Adversity and Neighborhood Environment with TBI Outcomes, builds upon our expertise in life course epidemiology, geospatial indicators of social determinants of health, and outcome modeling. We will collect new data on early life circumstances, which to date has been virtually unexplored in the TBIMS despite substantial evidence of impact on adult brain health. Our recent work additionally uncovered vast potential for using census tract-level data linkages to characterize participants' current environment; we will now use these methods to create neighborhood-level indicators of key social determinants of health. While traditional predictor variables account for only a small proportion of variance in TBI outcomes, this study will significantly advance knowledge regarding how early life and concurrent environmental factors relate to injury outcome, paving the way for actionable targets of policy change and individualized care delivery.
All activities of the NY-TBIMS, which include clinical care, research, knowledge translation, community reintegration, and advocacy, are guided by the objective of improving the health, functioning, participation, and overall well-being of people with TBI and their families. Strong support from the Mount Sinai Health System, an outstanding Advisory Committee of stakeholders, content experts and regional and national leaders in TBI advocacy, and a dedicated team of clinicians and researchers has allowed us to develop and strengthen the programs that make the Mount Sinai TBI program a model system of clinical care and research excellence.