The Journal of head trauma rehabilitation · 2025
Impact of Probable Deployment Traumatic Brain Injury on Post-9/11 Veteran's Productive Activity Participation After Service: A TVMI Study.
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Stromberg Kelsee M, Bouldin Erin D, Vogt Dawne, Miles Shannon R, Presson Angela P, Vanneman Megan E, Maloney Thomas N, Pugh Mary Jo
Аннотация
OBJECTIVE: To assess the impact of probable deployment traumatic brain injury (TBI) history on post-9/11 US veterans' participation in productive activities-including employment, caregiving, volunteering, and education-after military service.
METHODS: This secondary cross-sectional analysis of the Veterans Metrics Initiative (TVMI) study examined productive activities among 8946 veterans who transitioned from service in 2016 and completed the TVMI survey. Associations between probable deployment TBI and activity engagement were analyzed using bivariate analysis and multinomial logistic regression. Probable deployment TBI, the independent variable, was defined as a head injury with loss or alteration of consciousness. The dependent variable was engagement in productive activities, categorized as neither paid nor unpaid labor (reference), paid labor only, paid and unpaid labor, and unpaid labor only. Covariates included demographic characteristics, self-reported premilitary TBI, and a positive screen for probable post-traumatic stress disorder (PTSD) identified using the PC-PTSD-5 screening tool.
RESULTS: Veterans with probable deployment TBI were significantly less likely to engage in paid labor only (risk ratio [RR] = 0.66, 95% confidence interval [CI]: 0.55-0.79, P < .001) or paid and unpaid labor (RR = 0.79, 95% CI: 0.65-0.96, P = .023) compared to those without TBI. Conversely, they were more likely to engage in unpaid labor only (RR = 1.23, 95% CI: 1.02-1.48, P = .024). These associations remained after adjusting for covariates described above.
CONCLUSIONS: Productive activity engagement differed between veterans with and without probable deployment TBI. Veterans with probable deployment TBI were less likely to participate in paid labor and more likely to engage in unpaid or no labor. Additional support may be needed to facilitate their transition into the civilian workforce.
METHODS: This secondary cross-sectional analysis of the Veterans Metrics Initiative (TVMI) study examined productive activities among 8946 veterans who transitioned from service in 2016 and completed the TVMI survey. Associations between probable deployment TBI and activity engagement were analyzed using bivariate analysis and multinomial logistic regression. Probable deployment TBI, the independent variable, was defined as a head injury with loss or alteration of consciousness. The dependent variable was engagement in productive activities, categorized as neither paid nor unpaid labor (reference), paid labor only, paid and unpaid labor, and unpaid labor only. Covariates included demographic characteristics, self-reported premilitary TBI, and a positive screen for probable post-traumatic stress disorder (PTSD) identified using the PC-PTSD-5 screening tool.
RESULTS: Veterans with probable deployment TBI were significantly less likely to engage in paid labor only (risk ratio [RR] = 0.66, 95% confidence interval [CI]: 0.55-0.79, P < .001) or paid and unpaid labor (RR = 0.79, 95% CI: 0.65-0.96, P = .023) compared to those without TBI. Conversely, they were more likely to engage in unpaid labor only (RR = 1.23, 95% CI: 1.02-1.48, P = .024). These associations remained after adjusting for covariates described above.
CONCLUSIONS: Productive activity engagement differed between veterans with and without probable deployment TBI. Veterans with probable deployment TBI were less likely to participate in paid labor and more likely to engage in unpaid or no labor. Additional support may be needed to facilitate their transition into the civilian workforce.