Background: The purpose of this study is to compare the prevalence of self‐reported cardiovascular conditions among individuals with moderate to severe traumatic brain injury (TBI) to a propensity‐matched control cohort. Methods and Results: A cross‐sectional study described self‐reported cardiovascular conditions (hypertension, congestive heart failure [CHF], myocardial infarction [MI], and stroke) from participants who completed interviews between January 2015 and March 2020 in 2 harmonized large cohort studies, the TBI Model Systems and the National Health and Nutrition Examination Survey. Mixed‐effect logistic regression models were used to compare the prevalence of cardiovascular conditions after 1:1 propensity‐score matching based on age, sex, race, ethnicity, body mass index, education level, and smoking status. The final sample was 4690 matched pairs. Individuals with TBI were more likely to report hypertension (odds ratio [OR], 1.18 [95% CI, 1.08–1.28]) and stroke (OR, 1.70 [95% CI, 1.56–1.98]) but less likely to report CHF (OR, 0.81 [95% CI, 0.67–0.99]) or MI (OR, 0.66 [95% CI, 0.55–0.79]). There was no difference in rate of CHF or MI for those ≤50 years old; however, rates of CHF and MI were lower in the TBI group for individuals >50 years old. Over 65% of individuals who died before the first follow‐up interview at 1 year post‐TBI were >50 years old, and those >50 years old were more likely to die of heart disease than those ≤50 years old (17.6% versus 8.6%). Conclusions: Individuals with moderate to severe TBI had an increased rate of self‐reported hypertension and stroke but lower rate of MI and CHF than uninjured adults, which may be due to survival bias.

In rehabilitation research and practice, participation is defined as involvement in life situations and most often measured as frequency of engaging in these life situations. This narrow measurement approach overlooks that individuals perceive importance of and satisfaction with participation in activities in various life areas differently. The purpose of this study was to determine differences in meaningful participation (perceived importance and satisfaction) after moderate to severe traumatic brain injury (TBI) across age groups and to identify predictors of participation satisfaction. Secondary data analysis of a TBI Model Systems substudy, including the Participation Assessment with Recombined Tools-Subjective (PART-S) that rates participation importance and satisfaction in 11 life areas that we grouped into three domains (i.e., productivity, social relations, out-and-about). We identified differences across age groups (i.e., 16 to 24 years, 25 to 44 years, 45 to 64 years, and 65 + years) and predictors of participation satisfaction. Participation satisfaction in and importance of the 11 life areas varied across age groups. In all age groups, participants rated relationships as being of medium or high importance more often than other life areas. Older adults reported the highest participation satisfaction across life areas, despite having the lowest participation frequency. Consistent predictors of participation satisfaction were cognitive functioning and frequency of participation in the domain examined. Participation importance, satisfaction, and frequency are related, yet distinct, dimensions of participation that should all be measured to adequately evaluate meaningful participation. Future research should explore interventions across the lifespan that target modifiable predictors, like functional cognition and access to frequent participation in important life activities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Purpose of review: Traumatic Brain Injury (TBI) is a complex condition, with outcomes ranging from profound disability to remarkable recovery. Considerable variability in outcomes is observed, even among those with similar injury mechanisms, severity and neuropathological pattern. This indicates a need to explore resilience factors influencing TBI recovery. Recent findings: This narrative review synthesizes existing literature, focusing on individual, social, and community factors impacting resilience post-TBI. Recent research highlights how individual factors such as personality traits, coping strategies, and premorbid psychiatric history, as well as social and contextual factors, like social support and social determinants of health (SDoH) all impact TBI recovery. We also discuss clinical applications of resilience-focused interventions to promote health and wellbeing after TBI. Summary: An improved understanding of resilience factors and pathways to recovery post-TBI is crucial for optimizing outcomes. Future research should focus on developing comprehensive interventions addressing individual, social, and community-level factors to foster resilience and enhance TBI recovery.

Objective: To examine racial/ethnic disparities in community participation among veterans and active duty service members with traumatic brain injury (TBI). Setting: Five Department of Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs). Participants: Three hundred forty-two community-dwelling adults (251 White, 34 Black, and 57 Hispanic) with TBI enrolled in the VA TBIMS National Database who completed a 1-year follow-up interview. Mean age was 38.6 years (range, 19-84 years). Design: Cross-sectional analysis of a prospective observational cohort study. Main Measures: Community participation at 1 year postinjury assessed by 3 domains of the Participation Assessment with Recombined Tools–Objective (PART-O): Out & About, Productivity, and Social Relations. Results: Significant differences were observed among race/ethnicity groups in PART-O Productivity and Out & About domains without controlling for relevant participant characteristics; Productivity scores were significantly higher for non-Hispanic Black than for non-Hispanic White participants (t = 2.40, P = .0169). Out & About scores were significantly higher for Hispanic than for non-Hispanic White participants (t = 2.79, P = .0056). However, after controlling for demographic, injury severity, and 1-year follow-up characteristics, only differences in the Out & About domain remained statistically significant (t = 2.62, P = .0094), with scores being significantly higher for Hispanics than for non-Hispanic Whites. Conclusions: The results, which differ from findings from studies conducted in non-VA healthcare settings where there are greater racial/ethnic disparities in participation outcomes, could reflect differences between military and civilian samples that may reduce disparities.

Objective: Ecological momentary assessment (EMA) involves repeated collection of real-time self-report data, often multiple times per day, nearly always delivered electronically by smartphone. While EMA has shown promise for researching internal states, behaviors, and experiences in multiple populations, concerns remain regarding its feasibility in samples with cognitive impairments, like those associated with chronic moderate-to-severe traumatic brain injury (TBI).Methods: This study examines adherence to a 7-week high-frequency (5x daily) EMA protocol in individuals with moderate-to-severe TBI, considering changes in response rate over time, as well as individual participant characteristics (memory function, education, injury severity, and age).Results: In the sample of 39 participants, the average overall response rate was 65% (range: 5%–100%). Linear mixed-effects modeling revealed a small but statistically significant linear decay in response rate over 7 weeks of participation. Individual trajectories were variable, as evidenced by the significant effect of random slope. A better response rate was positively associated with greater educational attainment and better episodic memory function (statistical trend), whereas the effects of age and injury severity were not significant.Conclusions: These findings shed light on the potential of EMA in TBI studies but underscore the need for tailored strategies to address individual barriers to adherence.

We will study the impact of adolescent sports participation on early-adulthood health using longitudinal data from the National Study of Youth and Religion. We focus on two primary outcomes measured at ages 23–28 — self-rated health and total score on the PHQ9 Patient Depression Questionnaire — and control for several potential confounders related to demographics and family socioeconomic status. Comparing outcomes between sports participants and matched non-sports participants with similar confounders is straightforward. Unfortunately, an analysis based on such a broad exposure cannot probe the possibility that participation in certain types of sports (e.g., collision sports like football or soccer) may have larger effects on health than others. In this study, we introduce a hierarchy of exposure definitions, ranging from broad (participation in any after-school organized activity) to narrow (e.g., participation in limited-contact sports). We will perform separate matched observational studies, one for each definition, to estimate the health effects of several levels of sports participation. In order to conduct these studies while maintaining a fixed family-wise error rate, we deployed an ordered testing approach that exploits the logical relationships between exposure definitions. Our study will also consider several secondary outcomes including body mass index, life satisfaction, and problematic drinking behavior.