Improving access to cognitive rehabilitation treatment following mild traumatic brain injury

More than a million people in the US sustain a mild traumatic brain injury (mTBI) every year, and many report difficulties with attention, memory and other thinking abilities months and even years following their injury. A promising treatment option is cognitive rehabilitation, but the full-length (20 hours), in-person intervention is not feasible for many people due to time and financial constraints.

This study will evaluate a brief (6 hours), virtual cognitive rehabilitation intervention developed for individuals with persisting cognitive difficulties after mTBI. We will evaluate several outcomes related to improving patient care including treatment satisfaction, feasibility of this intervention when using telehealth and preliminary effectiveness. The proposed treatment aims to provide the same clinical impact of traditional cognitive rehabilitation while reducing burden and increasing access.

Preventing addiction related suicide

To evaluate the use of an existing selective suicide prevention intervention, Preventing Addiction Related Suicide (PARS), for use with Veterans by: 1) adapting and tailoring content to Veteran populations and 2) conducting an open trial within a VA substance use disorder intensive outpatient program.

Does the microbiome play a role in adverse outcomes following mTBI and PTSD?

The proposed research will be a preliminary investigation into the potential association between microbiota abundance, hormone levels, peripheral inflammation and current symptoms (psychiatric and cognitive) in Veterans with and without a history of mild traumatic brain injury (mTBI). This work has the potential to form a new line of research that could ultimately provide new treatment options for individuals who have persisting symptoms following mTBI.

The Life Enhancing Alcohol-management Program 2.0 (LEAP 2.0)

LEAP 2.0 builds on a longstanding partnership between the UW HaRRT Center and housing first residents, staff, and management of DESC. The pilot program was developed through a community based participatory research framework, and entails low-barrier, community-level, house-wide resident programming—including leadership opportunities, activities, and pathways to recovery. Results from the pilot indicated that LEAP participants reported more engagement in meaningful activities than their control counterparts. Further, higher levels of engagement with the LEAP predicted significant reductions in alcohol use and alcohol-related harm. To build on these promising findings, in LEAP 2.0, we will be conducting a 10-site, cluster-randomized controlled trial to assess LEAPs impact on substance use, health, cost and service utilization, as well as quality of life outcomes.

Sustaining quality

Several recent studies have found that for evidence-based psychosocial interventions (EBPIs) to be delivered more effectively, sustained quality, ongoing supervision, and guidance is critical.

This study will develop an electronic support tool to support quality delivery of PST that is based on clinician feedback. We hypothesize that supporting clinician delivery of EBPIs will result in enhanced quality of treatment and better patient outcomes.