In order to advance the development of tele-rehabilitation that addresses issues related to traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and related issues, this project will deploy and test two interventions designed to build strengths valuable for achieving personal goals such as in school and work. The interventions will be based on two different lines of theory for improving goal-directed functioning, targeting either goal-directed brain state regulation skills (GSR) or knowledge for optimizing brain functioning (OPT). Both interventions will utilize advances in tele-rehabilitation (e.g., online resources, digital apps, and coaching over tele-video) to provide access to guided learning experiences for Veterans in different locations and settings. We will examine the impact of these interventions on multiple levels of goal-directed functioning, and we will investigate changes in hypothesized neurocognitive pathways. Post-9/11 Veterans with a history of TBI (age 25-60) will be allocated to one of the two training interventions in a randomized, controlled design. Assessments will focus on indexing tiers of goal-directed functioning (neurocognitive tests, functional performance with complex tasks, and goal attainment in personal life) and will be collected for double-baseline, after training, and at 3 months follow-up. The knowledge generated by this project will inform Veteran-centered intervention development, including informing and providing tools for tele-rehabilitation that Veterans can access at home, in school, and other settings remote from VA facilities.

Public Health Relevance

As Veterans transition to community, success in achieving school, work and other goals are top priorities. However, difficulties with concentration, memory, irritability and other symptoms of cognitive-emotional dysregulation can ?derail? the life paths of Veterans with traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), and related issues. Many Veterans are interested in approaches to building their personal strengths ? approaches that help them help themselves. Barriers to care leave gaps for many Veterans. Our overall mission is to help Veterans build strengths for regulating attention, keeping key information in mind, staying on track, and following through despite challenges in order accomplish goals. This project will provide access to learning experiences to improve brain functioning via tele-rehabilitation. The project will inform Veteran-centered care that Veterans can access at home, in school, and in other settings.

Agency
National Institute of Health (NIH)
Institute
Veterans Affairs (VA)
Type
Non-HHS Research Projects (I01)
Project #
5I01RX003141-02
Application #
10051336
Study Section
Brain Health & Injury (RRD1)
Project Start
2019-11-01
Project End
2023-10-31
Budget Start
2020-11-01
Budget End
2021-10-31
Support Year
2
Fiscal Year
2021
Total Cost
Indirect Cost
Name
VA Northern California Health Care System
Department
Type
DUNS #
127349889
City
Mather
State
CA
Country
United States
Zip Code
95655