With an estimated annual incidence rate of 1.7 million, traumatic brain injury is a leading cause of death and disability in the United States. Annually, brain injury accounts for 53,000 deaths, 325,000 hospitalizations and more than one million visits to U. S. emergency rooms. Brain injury causes drastic life changes, with losses affecting survivors, their families, and society. An estimated 5.3 million people in the United States live with permanent brain injury-related disabilities. Estimates place the annual indirect and direct financial costs above $75 billion.
Traumatic Brain Injury Model Systems (TBIMS) and other researchers have expended considerable energy delineating outcomes. For example, researchers have thoroughly documented postinjury memory disturbance, executive skills dysfunction, slowness, visual dysfunction, poor coordination, impaired self-awareness, and behavioral disorders. Recent studies have identified a high prevalence of depression, with many survivors reporting feelings of hopelessness, diminished self-esteem, and social isolation. Undoubtedly brain injury also affects couples and family systems; caregivers commonly describe emotional distress, lack of respite, financial stress, and lack of community support.
The Virginia TBIMS program utilizes rigorous scientific methods to examine the benefits of two interventions. Projects focus on survivors and couples. One study examines a structured, curriculum-based approach to improve survivors’ resilience and adjustment. Examining the benefits of an intervention for couples is another major research area. Though many professionals agree that strengthening caregivers can enhance rehabilitation outcomes, there is little research regarding the benefits of interventions designed specifically to address the needs of couples after injury. We are also collecting data for the National Database and participating in a Collaborative Module project.
Home to this TBIMS program is Virginia Commonwealth University (VCU), a major provider of brain injury acute care and medical rehabilitation services for more than three decades. We have been an active collaborator in the brain injury model system program since 1987. Since program inception, we have: extended our system of care; developed new partnerships with service providers and advocacy organizations; improved outcome measurement techniques, and explored the development of innovative interventions. Consumer involvement, community based rehabilitation, relevance, and active dissemination to consumer and professional audiences have been cornerstones of program development and implementation.
Centrally located in Virginia, the university is a major provider of medical services to a large, culturally diverse population. As the state’s largest single provider, VCU Medical Center provides nearly one-third of Virginia’s indigent care. Uninsured patients represent 20 percent of all patients treated, substantiating our strong commitment to serve persons regardless of ability to pay. The VCU Rehabilitation Research Center and VCU Health System (VCUHS) are components of the VCU Medical Center, a major state-supported teaching institution. The more than 350 model systems manuscripts published by our interdisciplinary research team in the past 25 years substantiates assertions that the urban, academic health center setting is ideal for scientific research, innovation, collaboration, and dissemination.