title: Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial.
abstract: Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning.
  
  
  
  Interviews and intervention sessions were conducted in homes or by telephone.
  
  
  
  Eighty-one veterans with TBI at a VA polytrauma programme and a key family member.
  
  
  
  This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview.
  
  
  
  VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence.
  
  
  
  At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high.
  
  
  
  A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.
authors.affiliation: a Philadelphia Research and Education Foundation.|b Nursing Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA.
authors.forename: Laraine
authors.initials: L
authors.lastname: Winter
authors.affiliation: b Nursing Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA.|c Villanova University College of Nursing , Villanova , PA , USA.
authors.forename: Helene J
authors.initials: HJ
authors.lastname: Moriarty
authors.affiliation: d Medical Rehabilitation Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA.|e Perelman School of Medicine , University of Pennsylvania , PA , USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Robinson
authors.affiliation: f Thomas Jefferson University , School of Health Professions , Philadelphia , PA , USA.
authors.forename: Catherine V
authors.initials: CV
authors.lastname: Piersol
authors.affiliation: f Thomas Jefferson University , School of Health Professions , Philadelphia , PA , USA.
authors.forename: Tracey
authors.initials: T
authors.lastname: Vause-Earland
authors.affiliation: d Medical Rehabilitation Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Newhart
authors.affiliation: d Medical Rehabilitation Service , Department of Veterans Affairs Medical Center , Philadelphia , PA , USA.
authors.forename: Delores Blazer
authors.initials: DB
authors.lastname: Iacovone
authors.affiliation: g The Center for Innovative Care in Aging, School of Nursing , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Hodgson
authors.affiliation: g The Center for Innovative Care in Aging, School of Nursing , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000523:psychology* / Q000534:rehabilitation*; D015331:Cohort Studies; D062309:Community Integration; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Community reintegration; family; in-home service; rehabilitation; traumatic brain injury; veterans