Author ORCID Identifier

Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Paul Perrin, Ph.D

Second Advisor

Juan Arango Lasprilla, Ph.D

Third Advisor

Shawn Jones, Ph.D


The population of racially/ethnically diverse groups within the U.S. is growing at an exponential rate. The U.S. Census Bureau estimated the number of foreign-born individuals in the U.S. to be nearly 40 million or 13% of the total population (Grieco et al., 2012). Racially/ethnically diverse groups in the U.S. have a higher incidence of traumatic brain injury (TBI; Gary et al., 2009). Although racial/ethnic disparities have been documented in numerous outcomes, research has yet to thoroughly explore differences in rehabilitation outcomes for immigrants relative to U.S.-born individuals. The purpose of this study was to compare the functional and mental health outcomes over the first 10 years after TBI for individuals born in the U.S. vs. those who had immigrated to the U.S. For the current analyses, a sample of 12,161 individuals in the TBI Model Systems database with a coding for Country of Birth = US (N=10,662) vs. Other than the US (N=1,507) was used. Findings suggested that immigrants with TBI exhibited higher life satisfaction trajectories than those born in the U.S., even after controlling for demographic and injury-related covariates, but comparable levels of depression and anxiety. Immigrants also exhibited lower motor functional independence trajectories than those born in the U.S., again even after controlling for demographic and injury-related covariates. However, immigrants generally showed a stronger upward quadratic trajectory in motor functional independence with the greatest gains between the 5- and 10-year time points, whereas those born in the U.S. improved more quickly but then plateaued between the 5- and 10-year time points; these differential effects over time dissipated with the addition of demographic and injury-related covariates. Immigrants exhibited lower cognitive functional independence trajectories, as well as greater supervision needs trajectories, than those born in the U.S., even after controlling for demographic and injury-related covariates. These findings support current literature suggesting that racially/ethnically diverse group exhibit lower functional independence on the FIM when compared to White American groups. They may also suggest potential systematic barriers such as healthcare access and language barriers that may influence the frequency, rate, and quality of care received. The results highlight the importance of uncovering cultural distinctions and can aid in facilitating research examining immigration-based disparities following TBI.


© Chimdindu Ohayagha

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