Modular Scheduled Telephone Intervention for Caregivers of Persons With Traumatic Brain Injury: A Randomized Controlled Trial

In this study, we propose to conduct a randomized controlled trial to test the efficacy of a client- and community-centered intervention for caregivers of persons with traumatic brain injury (TBI) consisting of education and mentoring in solving caregiver and brain injury related problems affecting everyday life. The intervention will begin with a face-to-face introductory orientation and training session between a trained Research Care Mentor (RCM) and the designated caregiver prior to the TBI survivor’s discharge from the acute rehabilitation unit. During the first five months following rehabilitation discharge, the RCM will initiate an additional 7 to 10 contacts with the caregiver by telephone on a bi-weekly basis. Each telephone contact will include (a) instruction from one of a series of educational modules; (b) identification of current problems, concerns, and goals; (c) mentoring in the generation of potential solutions or strategies for those problems; and (d) evaluation of the effectiveness of previous action steps. Referral for services will be provided as needed. Support and consultation will be provided to the RCM during this process by a team of experienced rehabilitation clinicians including medicine, nursing, psychology, occupational therapy, vocational rehabilitation, and social work. At 6 months following rehabilitation discharge, we will compare quality of life (QOL) and emotional well-being for caregivers receiving the telephone intervention and caregivers receiving standard care. In addition, we will examine the social significance of the intervention (i.e., caregiver participation in the community, caregiver employment, and use of resources); the social validity of the intervention from the caregiver perspective (e.g., helpfulness and accessibility); and the effect of the intervention on caregiver knowledge and self-efficacy. While the primary focus of the proposed study is on caregivers, we will also investigate differences in QOL and emotional well-being for the TBI survivors based on caregiver group assignment. In order to examine the maintenance of intervention effects over time, similar outcome assessments will take place at 6 months after discharge from the hospital and 1 year following the date of injury. If this intervention is successful, it will improve the lives of caregivers and their effectiveness in providing care to individuals with TBI and, in turn, positively impact the lives of TBI survivors. There is marked variation in the long-term needs of people with TBI and their families depending on such factors as severity of injury, the pre-injury characteristics of the injured person, and the family/community in which that person lives. However, for most people with TBI, the cognitive, behavioral, and/or physical sequelae of TBI result in the need for assistance, supervision, or other forms of care giving for months or years after the injury.