A randomized practical behavioural trial of curriculum-based advocacy training for individuals with traumatic brain injury and their families.
OBJECTIVE
To test whether a curriculum-based advocacy training programme improves advocacy behaviour when compared to a matched group engaged in self-directed advocacy activities.


METHODS
Community-based randomized practical behavioural trial.


METHODS
Adults with moderate-severe TBI 1 or more years post-injury and their family members were recruited in Minnesota (4 years), Iowa and Wisconsin (each 3 years) and randomized into a curriculum-based or self-directed advocacy training group. Both groups met on the same day, at separate locations in the same city, once per month for 4 consecutive months.


RESULTS
Pre-post written and video testimony were rated using the Advocacy Behaviour Rating Scale (ABRS). Mean ABRS scores increased after intervention in both groups (curriculum n = 129, self-directed n = 128), but there was no significant difference in this increase between groups. When groups were combined, a significant pre-post improvement in mean ABRS scores was observed.


CONCLUSIONS
Curriculum-based advocacy training was not superior to a self-directed approach in improving ABRS scores. A significant improvement in expression of an advocacy message was observed when intervention groups were combined. These findings suggest that bringing together like-minded motivated individuals is more important than programme structure or content in changing advocacy behaviour.
a Department of Physical Medicine and Rehabilitation , Mayo Clinic , Rochester , MN , USA .
Allen W
AW
Brown
a Department of Physical Medicine and Rehabilitation , Mayo Clinic , Rochester , MN , USA .
Anne M
AM
Moessner
b Department of Psychiatry and Psychology , Mayo Clinic , Rochester , MN , USA .
Thomas F
TF
Bergquist
a Department of Physical Medicine and Rehabilitation , Mayo Clinic , Rochester , MN , USA .
Kathryn S
KS
Kendall
c Department of Health Science Research , Mayo Clinic , Jacksonville , FL , USA , and.
Nancy N
NN
Diehl
d Division of Biomedical Statistics and Informatics and Department of Neurology , Mayo Clinic , Rochester , MN , USA.
Jay
J
Mandrekar
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D001930:Brain Injuries / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D003479:Curriculum; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010344:Patient Advocacy / Q000193:education* / Q000592:standards; D011788:Quality of Life / Q000523:psychology
Consumer advocacy; government agencies; local government; patient advocacy; rehabilitation