title: A Randomized Controlled Trial of Assisted Intention Monitoring for the Rehabilitation of Executive Impairments Following Acquired Brain Injury.
abstract: Acquired brain injury (ABI) can impair executive function, impeding planning and attainment of intentions. Research shows promise for some goal-management rehabilitation interventions. However, evidence that alerts assist monitoring and completion of day-to-day intentions is limited.
  
  
  
  To examine the efficacy of brief goal-directed rehabilitation paired with periodic SMS text messages designed to enhance executive monitoring of intentions (assisted intention monitoring [AIM]).
  
  
  
  A randomized, double-blind, controlled trial was conducted. Following a baseline phase, 74 people with ABI and executive problems were randomized to receive AIM or control (information and games) for 3 weeks (phase 1) before crossing over to either AIM or no intervention (phase 2). The primary outcome was change in composite score of proportion of daily intentions achieved. A total of 59 people (71% male; 46% traumatic brain injury) completed all study phases.
  
  
  
  Per protocol crossover analysis found a significant benefit of AIM for all intentions [ F(1, 56) = 4.28; P = .04; f = 0.28; 3.7% mean difference; 95% CI = 0.1%-7.4%] and all intentions excluding a proxy prospective memory task [ F(1, 55) = 4.79; P = .033; f = 0.28, medium effect size; 3% mean difference; 95% CI = 0.3%-5.6%] in the absence of significant changes on tests of executive functioning. Intention-to-treat analyses, comparing AIM against control at the end of phase 1 revealed no statistically significant differences in the attainment of intentions.
  
  
  
  Combining brief executive rehabilitation with alerts may be effective for some in improving achievement of daily intentions, but further evaluation of clinical effectiveness and mechanisms is required.
authors.affiliation: 1 University of East Anglia, Norwich Research Park, Norwich, UK.|2 Acquired Brain Injury Rehabilitation Alliance, Cambridge, UK.|3 Princess of Wales Hospital, Cambridgeshire, UK.
authors.forename: Fergus
authors.initials: F
authors.lastname: Gracey
authors.affiliation: 3 Princess of Wales Hospital, Cambridgeshire, UK.|4 MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Fish
authors.affiliation: 4 MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Eve
authors.initials: E
authors.lastname: Greenfield
authors.affiliation: 2 Acquired Brain Injury Rehabilitation Alliance, Cambridge, UK.|3 Princess of Wales Hospital, Cambridgeshire, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bateman
authors.affiliation: 3 Princess of Wales Hospital, Cambridgeshire, UK.
authors.forename: Donna
authors.initials: D
authors.lastname: Malley
authors.affiliation: 3 Princess of Wales Hospital, Cambridgeshire, UK.|4 MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Hardy
authors.affiliation: 3 Princess of Wales Hospital, Cambridgeshire, UK.|4 MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ingham
authors.affiliation: 5 University of Glasgow, Glasgow, UK.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Evans
authors.affiliation: 4 MRC Cognition and Brain Sciences Unit, Cambridge, UK.
authors.forename: Tom
authors.initials: T
authors.lastname: Manly
mesh_terms: D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D040421:Cell Phone; D015928:Cognitive Behavioral Therapy; D018592:Cross-Over Studies; D004311:Double-Blind Method; D056344:Executive Function; D005260:Female; D005717:Games, Experimental; D006040:Goals; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: brain injuries; executive function; rehabilitation