Sociodemographic and Injury Characteristics Contribute to Ethnoracial Differences in Societal Participation After Traumatic Brain Injury.

Document Type

Article

Publication Date

2025

Publication Title

Archives of Physical Medicine and Rehabilitation

Abstract

OBJECTIVE(S): To investigate contextual factors that may contribute to ethnoracial differences in societal participation following traumatic brain injury (TBI), which is a common neurological condition and has varied symptom presentations. Participation captures re-integration into one's community and meaningful social roles. Prior literature indicated worse functional outcomes among Black and Hispanic individuals relative to White individuals.

DESIGN: This project was a secondary analysis of a de-identified archival dataset.

SETTING: General community.

PARTICIPANTS: The sample included 222 non-Hispanic White, 188 non-Hispanic Black, and 76 Hispanic participants with chronic TBI. The original, IRB-approved study recruited an English-speaking, community dwelling sample of 504 people, ages 18-64, from three TBI research centers in Houston, TX, Detroit, MI, and Birmingham, AL.

INTERVENTIONS: N/A MAIN OUTCOME MEASURE(S): Participation Assessment with Recombined Tools-Objective (PART-O).

RESULTS: There were significant group differences across sociodemographic and clinical characteristics, which were used as covariates (age, education years, marital status, pre-injury income, and time since injury) in the evaluation of ethnoracial differences in participation outcomes. There were significant differences in unadjusted participation outcomes across ethnoracial groups (ps < 0.01). When considering covariates, race was not a significant contributor to PART-O Total score (p = 0.36). However, significant group differences remained for participation domains.

CONCLUSIONS: Apparent ethnoracial differences in societal participation among people with TBI are at least partially driven by sociodemographic and injury characteristics. More specifically, baseline characteristics of age, education, and marital status are more meaningful contributors to differences in global societal participation than race/ethnicity. Subordinate aspects of participation yielded different findings, however. Societal participation, and its potential drivers, require further investigation among ethnoracial minoritized groups to promote health equity in TBI outcomes.

DOI

10.1016/j.apmr.2025.10.007

ISSN

1532-821X

PubMed ID

41167296

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