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Community Participation for People with Trauma Injuries: A Study Protocol of a Crossover Randomised Controlled Trial of the Effectiveness of a Community Mobility Group Intervention (CarFreeMe TI)

  • Stacey George (a1), Christopher Barr (a2), Angela Berndt (a3), Maria Crotty (a4), Rachel Milte (a5), Amy Nussio (a1) and Jacki Liddle (a6)...

Abstract

Background: Following traumatic brain and spinal cord injuries, maximising community participation leads to better physical and mental health outcomes.

Objectives: To determine the effectiveness and health system resource use of a group intervention (CarFreeMe TI) on community participation in people with complex trauma injuries.

Method: Randomised crossover trial of 54 participants, recruited from rehabilitation services in Adelaide, Australia. Inclusion criteria is a trauma injury, unable to return to full driving, aged over 18 years of age, adequate cognition/behavioural/communication abilities to participate in sessions and mobile. Exclusion criterion is living in setting where alternative transport is provided. Participants will be randomly assigned on a 1:1 allocation basis, to receiving Phase 1 CarFreeMe TI-group-based intervention or Phase 2 information related to transport options. Then, crossover to Phase 1 or 2 will occur. Primary outcome measure is community participation using a Global Positioning System. Secondary outcome measures include Community Mobility Self-efficacy Scale; CarFreeMe TI Transport Questionnaire, AQOL, EQ-5D-5L; Carer's Community Mobility Self-efficacy Scale and Modified Carer Strain Index for carers of participants. Outcome assessors will be blinded to group allocation. All analyses will be on an intention to treat basis with difference in community participation between the groups determined via a GLM ANOVA and the significance between groups on other measures using independent sample t-tests. It is hypothesised that the community mobility intervention (CarFreeMeTI) will result in increased community participation.

Discussion: The results will provide proof of concept information on the feasibility and inform allocation of resources for people with complex trauma injuries.

Trial registration: Australian and New Zealand Clinical Trials Register (ANZCTR): ACTRN12616001254482.

Copyright

Corresponding author

Address for correspondence: Stacey George. College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, 5001, Australia E-mail: stacey.george@flinders.edu.au.

References

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Alali, A.S., Burton, K., Fowler, R.A., Naimark, D.M., Scales, D.C., Mainprize, T.G., & Nathens, A.B. (2015). Economic evaluations in the diagnosis and management of traumatic brain injury: A systematic review and analysis of quality. Value in Health, 18 (5), 721734.
Barclay, L., McDonald, R., & Lentin, P. (2015). Social and community participation following spinal cord injury: A critical review. International Journal of Rehabilitation Research, 38 (1), 119.
Cairns, S., Harmer, C., Hopkin, J., & Skippon, S. (2014). Sociological perspectives on travel and mobilities: A review. Transportation Research Part A: Policy and Practice, 63 (5), 107117.
Classen, S., Levy, C., McCarthy, D., Mann, W.C., Lanford, D., & Waid-Ebbs, J.K. (2009). Traumatic brain injury and driving assessment: An evidence-based literature review. American Journal of Occupational Therapy, 63 (5), 580591.
Access Economics (2009). The economic cost of spinal cord injury and traumatic brain injury in Australia. Report by Access Economics for the Victorian Neurotrauma Initiative, vol. 31. Canberra: Access Economics.
Grimby, G. (2010). The importance of health economics in rehabilitation medicine. Journal of Rehabilitation Medicine, 42, 284285.
Hawley, C.A. (2001). Return to driving after head injury. Journal of Neurology, Neurosurgery & Psychiatry, 70 (6), 761766.
Hawthorne, G., Richardson, J., & Osborne, R. (1999). The assessment of quality of life (AQoL) instrument: A psychometric measure of health-related quality of life. Quality of Life Research, 8 (3), 209224.
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D. . . . Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20 (10), 17271736.
Hordacre, B., Barr, C., & Crotty, M. (2014). Use of an activity monitor and GPS device to assess community activity and participation in transtibial amputees. Sensors, 14 (4), 58455859.
Juengst, S.B., Adams, L.M., Bogner, J.A., Arenth, P.M., O'Neil-Pirozzi, T.M., Dreer, L.E. . . . Wagner, A.K. (2015). Trajectories of life satisfaction after TBI: Influence of life roles, age, cognitive disability, and depressive symptoms. Rehabilitation Psychology, 60 (4), 353364.
Liddle, J., Fleming, J., McKenna, K., Turpin, M., Whitelaw, P., & Allen, S. (2012). Adjustment to loss of the driving role following traumatic brain injury: A qualitative exploration with key stakeholders. Austratlian Occupational Therapy Journal, 59 (1), 7988. doi: 10.1111/j.1440-1630.2011.00978.x
Liddle, J., Fleming, J., Mckenna, K., Turpin, M., Whitelaw, P., & Allen, S. (2011). Driving and driving cessation after traumatic brain injury: Processes and key times of need. Disability and Rehabilitation, 33 (25–26), 25742586.
Liddle, J., Hayes, R., Gustafsson, L., & Fleming, J. (2014a). Managing driving issues after an acquired brain injury: Strategies used by health professionals. Australian Occupational Therapy Journal, 61 (4), 215223.
Liddle, J., Haynes, M., Pachana, N.A., Mitchell, G., McKenna, K., & Gustafsson, L. (2014b). Effect of a group intervention to promote older adults’ adjustment to driving cessation on community mobility: A randomized controlled trial. The Gerontologist, 54 (3), 409422.
Liddle, J., Turpin, M., Carlson, G., & McKenna, K. (2008). The needs and experiences related to driving cessation for older people. British Journal of Occupational Therapy, 71 (9), 379388.
Lorig, K., Stewart, A., Ritter, P., Gonzalez, V.M., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. California: Sage Publications.
McCrea, M., Iverson, G.L., McAllister, T.W., Hammeke, T.A., Powell, M.R., Barr, W.B., & Kelly, J.P. (2009). An integrated review of recovery after mild traumatic brain injury (MTBI): Implications for clinical management. The Clinical Neuropsychologist, 23 (8), 13681390.
Medical Services Advisory Committee (2016). Technical guidelines for preparing assessment reports for the Medical Services Advisory Committee – Medical service type: Therapeutic (Version 2.0). Canberra: Australian Government Department of Health.
National Institute for Health and Care Excellence (2013). Guide to the methods of technology appraisal 2013. London: National Institute for Health and Care Excellence.
Norweg, A. (2011). Patterns, predictors and associated benefits of driving a modified vehicle after spinal cord injury: Findings from the national spinal cord injury model systems. Archives of Physical Medicine & Rehabilitation, 92 (3), 477483.
Oddy, M., & da Silva Ramos, S. (2013). The clinical and cost-benefits of investing in neurobehavioural rehabilitation: A multi-centre study. Brain Injury, 27 (13–14), 15001507.
Pietrapiana, P., Tamietto, M., Torrini, G., Mezzanato, T., Rago, R., & Perino, C. (2005). Role of premorbid factors in predicting safe return to driving after severe TBI. Brain Injury, 19 (3), 197211.
Rapport, L.J., Hanks, R.A., & Bryer, R.C. (2006). Barriers to driving and community integration after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 21 (1), 3444.
Ross, P.E., Ponsford, J.L., Di Stefano, M., & Spitz, G. (2015). Predictors of on-road driver performance following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 96 (3), 440446.
Scholten, A.C., Haagsma, J.A., Panneman, M.J., Van Beeck, E.F., & Polinder, S. (2014). Traumatic brain injury in the Netherlands: Incidence, costs and disability-adjusted life years. PLoS one, 9 (10), e110905.
Thornton, M., & Travis, S.S. (2003). Analysis of the reliability of the Modified Caregiver Strain Index. The Journal of Gerontology, Series B, Psychological Sciences and Social Sciences, 58 (2), S129
van Heugten, C.M., Geurtsen, G.J., Derksen, R.E., Martina, J.D., Geurts, A.C., & Evers, S.M. (2011). Intervention and societal costs of residential community reintegration for patients with acquired brain injury: A cost-analysis of the Brain Integration Programme. Journal of Rehabilitation Medicine, 43 (7), 647652.
Vos T, F.A., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K. . . . Abraham, J. (2013). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380, 9859 21632196.
World Health Organization (WHO) (2001) International Classification of Functioning, Disability and Health. Geneva: WHO.
Williams, M.W., Rapport, L.J., Millis, S.R., & Hanks, R.A. (2014). Psychosocial outcomes after traumatic brain injury: Life satisfaction, community integration, and distress. Rehabilitation Psychology, 59 (3), 298.
Wood, R.L., McCrea, J., Wood, L., & Merriman, R. (1999). Clinical and cost effectiveness of post-acute neurobehavioural rehabilitation. Brain Injury, 13 (2), 6988.
Worthington, A.D., Matthews, S., Melia, Y., & Oddy, M. (2006). Cost-benefits associated with social outcome from neurobehavioural rehabilitation. Brain Injury, 20 (9), 947957.

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