Traumatic brain injury state planning grant: preparing for change in a rural state.
OBJECTIVE
The overarching purpose of this work was to generate a framework on which to build a traumatic brain injury (TBI) system-support action plan for individuals with a TBI living in a rural state.


METHODS
Four research questions were posed aimed at describing rural service/support needs and service satisfaction among persons with a TBI, as well as rural service/support availability as defined by providers. One hundred and ninety-four providers/agencies and 250 individuals/family members completed one of two versions (provider/agency, individual/family member) of a Needs and Resources Assessment.


RESULTS
Data analyses indicated that the majority of individual respondents lived at an impoverished income level and lived with a TBI for approximately 12 years. Quality of life was perceived as significantly lower after the TBI than before. Employment decreased significantly following a TBI. Reasons for unemployment included a perceived inability to work, problems regarding proper accommodation and/or perceptions regarding being chosen as suitable job candidates.


CONCLUSIONS
Provider data confirmed that many important services are rarely available or specific to TBIs. Basic assistance with employment, cognitive training and occupational therapy were among those most needed. Paradoxically, a high proportion of individuals reported feeling satisfied with most services. Applications of these data along with recommendations for other rural states are described.
Institute of Rural Health, Idaho State University, Pocatello, ID, USA. spearuss@isu.edu
Russell C
RC
Spearman
B Hudnall
BH
Stamm
Laura J
LJ
Tivis
D001930:Brain Injuries / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006289:Health Planning Support; D006295:Health Resources / Q000600:supply & distribution; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007061:Idaho / Q000453:epidemiology; D008297:Male; D017060:Patient Satisfaction; D019035:Rural Health Services / Q000458:organization & administration*; D013221:State Health Plans; D014481:United States / Q000453:epidemiology