The COVID-19 pandemic has altered mental health care delivery like no other event in modern history. The purpose of this study was to document the magnitude of that effect by examining (a) the amount of psychologists' telepsychology use before the COVID-19 pandemic, during the pandemic, and anticipated use after the pandemic; as well as (b) the demographic, training, policy, and clinical practice predictors of these changes. This study used a cross-sectional, national online design to recruit 2,619 licensed psychologists practicing in the United States. Prior to the COVID-19 pandemic, psychologists performed 7.07% of their clinical work with telepsychology, which increased 12-fold to 85.53% during the pandemic, with 67.32% of psychologists conducting all of their clinical work with telepsychology. Psychologists projected that they would perform 34.96% of their clinical work via telepsychology after the pandemic. Psychologists working in outpatient treatment facilities reported over a 26-fold increase in telepsychology use during the pandemic, while those in Veterans Affairs medical centers only reported a sevenfold increase. A larger increase in percentage telepsychology use occurred in women, in psychologists who reported an increase in telepsychology training and supportive organizational telepsychology policies, and in psychologists who treated relationship issues, anxiety, and women's issues. The lowest increases in percentage telepsychology use were reported by psychologists working in rural areas, treating antisocial personality disorder, performing testing and evaluation, and treating rehabilitation populations. Although there was a remarkable increase in telepsychology use during the COVID-19 pandemic, individual and practice characteristics affected psychologists' ability to adopt telepsychology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Despite decades of low utilization, telemedicine adoption expanded at an unprecedented rate during the COVID-19 pandemic. This study examined quantitative and qualitative data provided by a national online sample of 228 practicing physicians (64% were women, and 75% were White) to identify facilitators and barriers to the adoption of telemedicine in the United States (U.S.) at the beginning of the COVID-19 pandemic. Logistic regressions were used to predict the most frequently endorsed (20% or more) barriers and facilitators based on participant demographics and practice characteristics. The top five reported barriers were: lack of patient access to technology (77.6%), insufficient insurance reimbursement (53.5%), diminished doctor-patient relationship (46.9%), inadequate video/audio technology (46.1%), and diminished quality of delivered care (42.1%). The top five reported facilitators were: better access to care (75.4%), increased safety (70.6%), efficient use of time (60.5%), lower cost for patients (43%), and effectiveness (28.9%). Physicians’ demographic and practice setting characteristics significantly predicted their endorsement of telemedicine barriers and facilitators. Older physicians were less likely to endorse inefficient use of time (p < 0.001) and potential for medical errors (p = 0.034) as barriers to telemedicine use compared to younger physicians. Physicians working in a medical center were more likely to endorse inadequate video/audio technology (p = 0.037) and lack of patient access to technology (p = 0.035) as a barrier and more likely to endorse lower cost for patients as a facilitator (p = 0.041) than providers working in other settings. Male physicians were more likely to endorse inefficient use of time as a barrier (p = 0.007) than female physicians, and White physicians were less likely to endorse lower costs for patients as a facilitator (p = 0.012) than physicians of color. These findings provide important context for future implementation strategies for healthcare systems attempting to increase telemedicine utilization.

BACKGROUND: Research has found that Hispanics with traumatic brain injury (TBI) have reduced functional outcomes compared to non-Hispanic Whites, including lower probabilities of post-injury employment. However, previous studies were cross-sectional, combined racial/ethnic minority groups, and did not examine the factors that predict return to work of Hispanics longitudinally. OBJECTIVE: To determine the demographic and injury-related predictors of employment probability trajectories during the first 10 years after TBI. METHODS: 1,346 Hispanics in the TBI Model Systems Database were included. Hierarchical linear modeling was used to examine baseline predictors of employment probability trajectories across this time period. RESULTS: Employment probability demonstrated a quadratic movement over time, with an initial increase followed by a plateau or slight decrease. Hispanics with TBI had higher employment probability trajectories if they had been younger at the time of injury, spent less time in posttraumatic amnesia, had greater years of education, had been employed at the time of injury, had higher annual earnings at the time of injury, and had experienced a non-violent mechanism of injury. CONCLUSION: Culturally adapted treatment programs with a focus on early intervention incorporating vocational rehabilitation and employment programs for Hispanics with TBI who present with these risk factors are needed.

Purpose To identify life satisfaction trajectories at 1-10 years post-traumatic brain injury (TBI) and examine which demographic and injury characteristics at the time of injury are associated with those trajectories. Methods Participants included 1,051 Hispanic individuals from the multi-site, longitudinal TBI Model Systems (TBIMS) database. Individuals were enrolled after sustaining a TBI and while undergoing inpatient rehabilitation at a TBIMS site; they were included if they completed the Satisfaction with Life Scale during one or more follow-up data collections at 1, 2, 5, or 10 years after TBI. Results A linear (straight-line) movement of life satisfaction trajectories was the best fit to the data. Across the overall sample, life satisfaction increased over time, with higher trajectories for Hispanic individuals who had been partnered at baseline, born outside the US and experienced a nonviolent injury cause. There were no significant interactions between time and any of these main effect predictors, suggesting no differential change over time in life satisfaction trajectories as a function of these characteristics. Conclusions Results revealed increases in life satisfaction over time among Hispanic individuals with TBI and shed light on critical risks and protective factors that may inform targeted rehabilitation services with this underserved group.

This study evaluated the relationships among pain, mental health symptom severity, life satisfaction, and understanding from others in veterans with spinal cord injury (SCI). A sample of 221 individuals with SCI were interviewed by a psychologist during their annual evaluation in a Veterans Affairs medical center in an urban Mid-Atlantic region. Participants completed single-item, Likert-scale measures of life satisfaction (McGuire Health Impact on Participation [M-HIP]), pain severity (M-HIP), and understanding of others (from a modified Appraisals of DisAbility Primary and Secondary Scale-Short Form [ADAPSS-sf]), along with the Patient Health Questionnaire-4 (PHQ-4), a measure of mental health symptom severity. In linear regression models, pain (β = .29, p < .001) and understanding from others (β = −.28, p < .001) were significantly associated with mental health symptom severity with a marginally significant interaction effect (β = −.32, p = .099). Pain (β = −.33, p < .001) and understanding from others (β = .32, p < .001) were also significantly associated with life satisfaction; however, there was no significant interaction (β = .22, p = .234). This study showed that understanding from others and pain are important factors related to mental health and life satisfaction for veterans with SCI and highlights interventions targeting these relations.

Traumatic brain injury (TBI) can lead to impairments in motor and cognitive function and reduced life satisfaction. TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the United States and elevated likelihood for fatality and severe complications. This study investigated whether disparities in functional and life satisfaction outcomes exist longitudinally over the 5 years after complicated mild, moderate, or severe TBI between Native Americans and White individuals; it further explored which demographic and injury-related covariates account for them. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury-severity matched Native American and White pairs (total n = 160). A series of longitudinal hierarchical linear models found that Native Americans experienced significantly lower Functional Independence Measure Cognitive and Motor trajectories than Whites; however, life satisfaction was comparable. Native Americans had declining cognitive function over time relative to a slight increase in White individuals. This differential movement dissipated with the addition of employment status at the time of injury and type of health insurance. These results demonstrate a profound need to further investigate the cultural and contextual variables unique to Native Americans that underlie these differences and highlight the importance of culturally responsive treatment and rehabilitation in bridging the gap in recovery. (PsycInfo Database Record (c) 2025 APA, all rights reserved).