Efficacy and Implementation Planning Across the Veterans Affairs Polytrauma System of Care: Protocol for the REACH Intervention for Caregivers of Veterans and Service Members With Traumatic Brain Injury (Preprint)

Abstract

BACKGROUND The responsibility of care for Veterans and Service Members (V/SMs) with traumatic brain injury (TBI) often defaults to informal family caregivers. Caregiving demands considerable knowledge, skill, and support to facilitate the health and well-being of V/SMs and themselves. Persistent and common TBI caregiver issues include strain, depression, and anxiety. While evidence-based, brief interventions have been developed and implemented for family caregivers in Veteran neurodegenerative populations, few interventions have been developed, adapted or tested to support the unique needs of caregivers of V/SMs with TBI. OBJECTIVE This study will adapt and test an evidence-based, personalized, six-session telehealth caregiver intervention, “Resources for Enhancing All Caregivers’ Health” (REACH), to meet the unique needs of caregivers of V/SMs with TBI. If successful, a community-based participatory research team will develop an implementation plan to roll out REACH TBI across the national VA Polytrauma System of Care (PSC). METHODS This mixed-methods, crossover waitlist control clinical trial will use a Type 1 Hybrid Effectiveness-Implementation approach to adapt and then test the effects of REACH TBI on key TBI caregiver outcomes. RESULTS This study was funded by the Department of Defense in September 2023. It was approved by the institutional review board at the University of Virginia in November 2023. Participant enrollment and data collection will begin in 2024. CONCLUSIONS If effective, REACH TBI will be the first evidence-based intervention for caregivers of V/SMs with TBI that can be scaled to implement across the VA PSC and fill a notable gap in clinical services. CLINICALTRIAL The REACH Intervention for Caregivers of Veterans and Service Members With TBI (REACH TBI) NCT06111794 https://clinicaltrials.gov/study/NCT06111794