Community-Based Organizations and Development of Implementation Strategies for Brain Injury Screening Resulting from Intimate Partner Violence

亲密伴侣暴力造成的脑损伤筛查的社区组织和实施策略的制定

• 批准号: 10734518
• 负责人: Shireen Sheela Rajaram
• 金额: $ 51.18万
• 依托单位: UNIVERSITY OF NEBRASKA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10734518
• 关键词: Address; Adoption; Alzheimer' s Disease; Anoxia; Anxiety; Brain; Brain Injuries; Cessation of life; Client; Communities; Data; Detection; Development; Dissemination and Implementation; Distress; Effectiveness; Face; Fatigue; Future; Goals; Guidelines; Head; Headache; Health; Hypoxia; Injury; Intervention; Knowledge; Maintenance; Memory; Mental Depression; Methods; Neck; Nervous System Trauma; Neurologic Deficit; Outcome; Oxygen; Patients; Perception; Personal Satisfaction; Persons; Policies; Population; Practical Robust Implementation and Sustainability Model; Process; Provider; Public Health; Quality of life; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recovery; Reporting; Risk; Scientific Advances and Accomplishments; Screening Result; Secondary Prevention; Secondary to; Sleep; Suicide; Survivors; Symptoms; Testing; Trauma; Traumatic Brain Injury; Violence; Vulnerable Populations; Woman; Women' s Group; brain tissue; community organizations; contextual factors; evidence base; experience; health care settings; high risk; implementation process; implementation strategy; improved; intimate partner violence; knowledge base; neurological rehabilitation; novel; poor health outcome; routine practice; routine screening; screening; tv watching

PROJECT SUMMARY/ABSTRACT People who experience repeated brain injuries (BIs) before the brain recovers from the initial trauma are at a high risk for neurological deficits, depression, suicide, and Alzheimer-like symptoms. Women who experience intimate partner violence (IPV) are at high risk for injuries to their head, neck and face – potentially resulting in an acquired BI. Among IPV survivors, BI can occur due to a traumatic brain injury (TBI) resulting from a bump, blow, or jolt to the head or through strangulation. BI can have long term consequences on IPV survivors' well- being and quality of life. Comprehensive screening among this vulnerable population and timely neurorehabilitation interventions (i.e., referral to, and receipt of, evidence-based approaches to mitigate BI- related health outcomes) have the potential to mitigate the impact of IPV-related BI and improve health outcomes. Despite the high risk of BI among IPV survivors and the availability of evidence-based approaches to address BI, there are no standard guidelines for BI screening in this group of women. The long-term goal is to advance scientific understanding of implementation strategies related to the secondary prevention of IPV- related BI that will inform future policies for timely screening, referral, and neurorehabilitation and ultimately reduce neurological damage among this population. The objective of this project is to examine how screening and detection of IPV-related BI can be effectively integrated into the workflow for community-based organizations (CBOs) serving IPV survivors using a participatory approach. The central hypothesis has been formulated based on preliminary studies and posits that CBO and stakeholder derived implementation strategies can improve the adoption, implementation, and maintenance of timely screening/detection and referral of IPV survivors at risk for a BI. Using the PRISM/RE-AIM framework and a participatory approach of community-engaged dissemination and implementation, these aims will be pursued. Aim 1: To evaluate adoption, implementation, and sustainability strategies of a brain injury screening intervention of IPV survivors at CBOs with and without stakeholder developed implementation strategies. Aim 2. To determine the reach and effectiveness of a brain injury screening intervention at CBOs serving survivors of IPV. Exploratory Aim. Determine client and CBO implementer's perception of the screening intervention and implementation strategies used in the project. The expected outcome is to increase currently limited knowledge of potential implementation strategies to integrate routine screening and referral for IPV-related BI. This outcome is expected to significantly contribute to the knowledge base needed to fully integrate the routine screening and referral of IPV-related BI in CBOs serving IPV survivors. The project will also allow for the identification of potential screening and referral strategies that can be used to connect patients with IPV-related BI to evidence- based approaches to mitigate poor health outcomes and identify methods to achieve secondary prevention.

项目概要/摘要 在大脑从最初的创伤中恢复之前经历过反复脑损伤 (BI) 的人处于危险状态。 出现神经缺陷、抑郁、自杀和阿尔茨海默样症状的高风险女性。 亲密伴侣暴力 (IPV) 的头部、颈部和面部受伤风险很高，可能会导致 获得性 BI。在 IPV 幸存者中，BI 可能是由于碰撞造成的创伤性脑损伤 (TBI) 造成的， 头部受到打击、摇晃或勒死可能会对 IPV 幸存者的健康产生长期影响。 并及时对这一弱势群体进行全面筛查。 神经康复干预措施（即转介和接受基于证据的方法来减轻 BI- 相关的健康结果）有可能减轻 IPV 相关 BI 的影响并改善健康 尽管 IPV 幸存者中 BI 的风险很高并且有基于证据的方法。 为了解决 BI，目前尚无针对该女性群体进行 BI 筛查的标准指南。 促进对 IPV 二级预防相关战略实施的科学认识 相关的 BI 将为未来的及时筛查、转诊和神经康复政策提供信息，并最终 减少该人群的神经损伤 该项目的目的是研究如何进行筛查。 IPV相关BI的检测可以有效地集成到基于社区的工作流程中 使用参与式方法为 IPV 幸存者提供服务的组织 (CBO) 的中心假设是。 根据 CBO 和利益相关者得出的实施初步研究和立场制定 策略可以改善及时筛查/检测和维护的采用、实施和维护 使用 PRISM/RE-AIM 框架和参与式方法将有风险的 IPV 幸存者转介至 BI。 目标 1：评估。 IPV 幸存者脑损伤筛查干预措施的采用、实施和可持续性策略 在有或没有利益相关者实施的 CBO 中制定了战略。 目标 2. 确定影响范围。 以及为 IPV 幸存者提供服务的 CBO 脑损伤筛查干预措施的有效性。 确定客户和 CBO 实施者对筛查干预和实施的看法 该项目中使用的策略的预期成果是增加目前有限的潜力知识。 整合 IPV 相关 BI 的常规筛查和转诊的实施策略。 预计将为充分整合常规筛查和治疗所需的知识库做出重大贡献 在为 IPV 幸存者提供服务的 CBO 中转介与 IPV 相关的 BI。 潜在的筛查和转诊策略可用于将 IPV 相关 BI 患者与证据联系起来 减轻不良健康结果的基础方法，并确定实现二级预防的方法。