Background: Brain injury among survivors of gender-based violence (GBV) is a critical issue, with 75-92% of women likely experiencing traumatic brain injury (TBI) from facial, head, and neck injuries. Research in Canada reveals a significant lack of awareness and research regarding TBI among both GBV service providers and survivors, which limits supports available to those affected. The intersection of GBV and TBI is important, as each is associated with cognitive, mental, emotional, and physical health challenges as well as elevated rates of unemployment, poverty, and houselessness. These issues lead to considerable economic impacts, including lost income, and higher costs for social and health-related services, thereby highlighting the need for GBV-TBI to be widely recognized and uniquely addressed.

Aim: This project addressed the gaps in research, support, and education for GBV-TBI survivors by piloting and evaluating a trauma-informed, multi-sectoral program. Utilizing the RE-AIM framework, the study assessed the effectiveness of a live-adapted program across diverse settings and populations in Canada. This program is survivor-led and developed with the support of WomenatthecentrE's Survivor Expert Collective (WE SEC).

Methods: Twenty-five survivors from across Canada participated in a 20-week pilot program. An intake worker assisted survivors in identifying personal goals and necessary accommodations before joining the program. Participants completed a pre-survey to gather demographic data, health information, and details on their respective GBV-TBI causes and symptoms, along with their knowledge of any associated coping strategies.

Survivors were matched with peer navigators, who provided one-on-one sessions of peer support, advocacy, system navigation, and referral services. In addition, participants could engage in virtual peer support groups, workshops, and group activities, such as music therapy, yoga, naturopathy, speech language pathology, and psychotherapy. Participants completed four interim surveys over the 20 weeks to ascertain any gained knowledge and experiences and to provide, feedback allowing for real-time adaptations of the program. Upon completion of the program, a post-survey and a follow-up focus group were administered to evaluate the effectiveness and impact of the program. Quantitative data was analyzed using SPSS, while qualitative data and thematic coding was processed through MAXQDA.

Results: Participants benefited from project involvement through direct support for GBV/TBI related challenges. Some of these benefits included increased education around GBV and TBI care practices, pain management, and effective communications. Urgent needs around food access, housing, and financial security were also addressed. Participants stated feeling increased confidence and self-esteem, being better equipped to manage stress and GBV/TBI related symptoms with an overall increase in sense of community and agency.

Conclusion: The findings from this study will advance understanding of how to support survivors of GBV-TBI more effectively, and our knowledge mobilization framework will ensure adaptable sustainability efforts across the nation.

Introduction: Traumatic brain injury (TBI) can impact various aspects of an individual’s life. Individuals with TBI often have complex healthcare needs both in the acute and long-term stages of their injury. As individuals with TBI are navigating through life after the injury, community integration is often a priority to improve quality of life. However, there is little known about the long-term experiences of community integration after TBI.

Objective: To explore the perceptions and experiences of community integration for individuals living with TBI in the community.

Method: This qualitative study used a descriptive phenomenological approach. Data was obtained from focus groups, comprised from a larger mixed-methods study. Participants were recruited through convenience sampling in British Columbia, Canada, and included if they were adults with TBI. A semi-structured interview guide on factors affecting individuals with TBI was developed in collaboration with patient partners with lived experience of TBI. Interviews were conducted with four focus groups, comprising of three to four individuals, online via Zoom. These interviews were audio- and video-recorded, and transcribed verbatim. Data were analyzed using codebook thematic analysis, and multiple investigators were involved in the data analysis process.

Results: Participants included 13 adults with TBI, between the ages of 25 and 64, who sustained their injuries between 1 and more than 20 years ago. Experiences of community integration were illustrated through three themes relating to employment or productive activity, independent living, and social activity: (1) ‘Am I left on my own?’ explored the support systems available after TBI, (2) ‘One size fits all’ described the response of society to TBI, and (3) ‘Adapting to a new normal’ highlighted the response of participants to a changed reality.

Conclusion: Understanding the long-term perceptions and experiences of community integration after TBI can improve public awareness and education to facilitate community integration, through acceptance and understanding. In addition, such perceptions and experiences may inform interventions that help improve the quality of life of individuals with TBI who are living in the community.

Introduction: Participation is an outcome measure used in healthcare, conceptually imbedded in the social environment in which people live. Previous studies identified meaningfulness, self-determination, and a sense of belonging as defining qualities of participation. Participation measures vary in their focus on objective (e.g. independence or frequency) or subjective components, and vary in their included activities, resulting in limitations in comparing outcomes. Most studies show the primary predictors of participation are social factors including race, education, and marital status of the individual with the TBI, rather than injury severity, which highlights the impact of these social determinants of health.

Purpose: This study seeks to explore the relationship between the experience of participation and the social environment to understand disparate outcomes. This study used a social ecological perspective to explore how persons of color with TBI experience participation in relation to immediate support, community, and societal systems.

Methods: The qualitative study interviewed dyads consisting of a person of color with a TBI and a person they identified as important in their lives. The design used stratified purposive sampling across age group, gender, race, and participation outcome score on the PART-O. Data collection included an interview with the dyad and observations on a brief activity, providing dialogic narrative, visual narrative, and behavioral observations.

Results: The first stage of analysis used the themes meaningfulness, self-determination, belonging, (dis)satisfaction, and the social ecological levels of immediate support, community, and society. Variations were identified across all participation qualities. In some experiences, solitary, immediate social environment, and community functioned separately; others chose activities at one level based on another social level. Data reflected a complex interplay between the brain injury and other social and medical issues impacting participation. Gaps appeared between the positive narrative of some persons with TBI and their paucity in participation performance.

Conclusions: The breadth of variation in experiences of participation suggests quantitative measures need to allow for variations. Participation is best understood through both subjective measures, including resilient narratives, and objective indicators of performance. Healthcare practices should incorporate the person’s medical and social complexity into individualized interventions and goals, and programs based on a social model could better address the barriers to participation.