Sociodemographic and Injury Characteristics Contribute to Ethnoracial Differences in Societal Participation After Traumatic Brain Injury.

OBJECTIVE

This study aimed to investigate contextual factors that may contribute to ethnoracial differences in societal participation after traumatic brain injury (TBI), which is a common neurologic condition and has varied symptom presentations. Participation captures reintegration into one's community and meaningful social roles. Prior literature indicated worse functional outcomes among Black and Hispanic individuals relative to White individuals.

DESIGN

This project was a secondary analysis of a de-identified archival dataset.

SETTING

General community.

PARTICIPANTS

The sample included 222 non-Hispanic White, 188 non-Hispanic Black, and 76 Hispanic participants with chronic TBI. The original, IRB-approved study recruited an English-speaking, community dwelling sample of 504 people (N=504), aged 18-64 years, from 3 TBI research centers in Houston, TX, Detroit, MI, and Birmingham, AL.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Participation Assessment with Recombined Tools-Objective (PART-O).

RESULTS

There were significant group differences across sociodemographic and clinical characteristics, which were used as covariates (age, education years, marital status, preinjury income, and time since injury) in the evaluation of ethnoracial differences in participation outcomes. There were significant differences in unadjusted participation outcomes across ethnoracial groups (Ps<.01). When considering covariates, race was not a significant contributor to PART-O total score (P=.36). However, significant group differences remained for participation domains.

CONCLUSIONS

Apparent ethnoracial differences in societal participation among people with TBI are at least partially driven by sociodemographic and injury characteristics. More specifically, baseline characteristics of age, education, and marital status are more meaningful contributors to differences in global societal participation than race/ethnicity. Subordinate aspects of participation yielded different findings, however. Societal participation and its potential drivers require further investigation among ethnoracial minoritized groups to promote health equity in TBI outcomes.