DOI
https://doi.org/10.25772/VCQG-CX74
Author ORCID Identifier
https://orcid.org/0000-0002-1348-4214
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Psychology
First Advisor
Paul Perrin
Second Advisor
Bruce Rybarczyk
Third Advisor
Eric Benotsch
Fourth Advisor
Natalie Dautovich
Fifth Advisor
Alicia Borre Montealegre
Abstract
Traumatic brain injury (TBI) disproportionately affects minoritized populations within the U.S., especially Native Americans who are more likely to experience a more severe or fatal TBI than White individuals. The current study used a subsample of 63 Native Americans with TBI from the TBI Model Systems (TBIMS) database matched by age, sex, and injury severity to 63 White individuals to examine disparities in community participation, as measured by the Participation Assessment with Recombined Tools—Objective (PART-O), over the five years following TBI. Analysis of variance (ANOVA) and chi-square tests revealed Native Americans were less likely to be employed prior to injury, less likely to have private insurance, more likely to report problematic alcohol use in the month prior to injury, and more likely to have lower education attainment compared to their demographically matched White counterparts. A series of hierarchical linear models (HLMs) revealed Native Americans demonstrated lower Out and About scores but statistically equivalent Social and Productivity scores compared to White individuals with TBI. The difference in Out and About scores did not change as a function of time, and the overall difference between the two groups dissipated with the inclusion of the statistically different sociodemographic variables. Both educational attainment and type of insurance were statistically significant predictors of Out and About trajectories. These results highlight important predictors that can help rehabilitation clinicians more accurately identify individuals who may be at risk for lower community participation following inpatient TBI rehabilitation.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-30-2024