Integrated care pathways for Black persons with traumatic brain injury: a protocol for a critical transdisciplinary scoping review

Abstract

Background: Current understandings of the etiology of traumatic brain injury (TBI) and the trajectory of care significantly lack consideration for the inclusion of Black populations. The global prevalence of TBI is increasing, particularly in North America and Europe where approximately 65 million people are affected every year. Although community integration is an ultimate goal of rehabilitation post injury, persons with TBI, particularly Black populations continually face challenges with regards to unmet needs along the continuum of care including meaningful participation and vocation, resulting in occupational deprivation. While integrated care is seen as an appealing approach to service delivery, little is known about what this means for Black people with TBI. This protocol produces the first critical transdisciplinary (CTD) scoping review mapping the extent, range, and nature of integrated care pathways for Black people experiencing TBI. Methods: CTD provides an analytical tool with a health equity lens that will be applied as both a methodology and theory for undertaking this review. Under the methodological guidance of Arksey and O'Malley, CTD will be used to map the literature and better understand the elements of integrated care pathways for Black people experiencing TBI. To identify the published literature, several databases will be searched including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and Sociological Abstracts. Discussion: The application of CTD compels health-care providers, administrators, clinician-scientists, rehabilitation specialists, and scholars in the field of TBI and integrated care to reexamine hidden assumptions about racism, racialization, and Blackness that are often embedded in current visions of health for all. The health equity lens of CTD asks about who is accounted for in the research and clinical literature and who is absented. It is anticipated that applying the health equity lens of CTD will provide a critical examination of the literature and illuminate significant implications for integrated care for Black persons experiencing TBI. Systematic review registration: Not applicable.

Assessment of the individual and compounding effects of marginalization factors on injury severity, discharge location, recovery, and employment outcomes at 1 year after traumatic brain injury

“…Intersectionality theory has demonstrated how multiple marginalities combine to create a person's unique disadvantages and, therefore, must be conceptualized as a whole (4). Despite the exponential growth of cumulative effect approaches in social and health disparity research, limited research exists within traumatic brain injury (TBI) populations (5)(6)(7)(8)(9).…”

Integrated Care Pathways for Black Persons With Traumatic Brain Injury: A Critical Transdisciplinary Scoping Review of the Clinical Care Journey

“…Effort that attempts to frame the struggle of all underserved populations, including racial minorities, as a single and isolated initiative in addressing health inequities is limited in its analysis and impact. To bridge this gap, this scoping review was undertaken to address the following objectives: (a) to summarize the extent, nature, and range of care pathways that consider Black populations, (b) summarize how Blackness, race, and racism are conceptualized in the literature, (c) determine how Black people come to access care pathways, and (d) identify how care pathways consider the mechanism of injury and implications for human occupation (Omar et al, 2020). Addressing the scope of the literature also involved consideration for how concepts of sex and gender were positioned and applied in the included studies.…”