From Military to Community Life: Reintegrating Veterans with Invisible Injuries

NIH RePORTER · VA · IK2 · · view on reporter.nih.gov ↗

Abstract

Background: The rehabilitation and health care needs of Veterans who have served in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) have led to increased awareness of “invisible injuries,” a term that calls attention to mental health conditions and traumatic brain injuries (TBI). Despite increased awareness about the prevalence of post-traumatic stress, TBIs, and depressive symptoms among post OEF/OIF/OND Veterans, the long-term effects and cost of these conditions are still poorly understood compared to wounds or more visible physical conditions. In particular, critical gaps remain in understanding the process of recovery from injuries and reintegration into community life following military service. These challenges are particularly difficult for Veterans with invisible injuries -- conditions such as TBIs and mental health-related distress that may not be readily apparent to others. An RR&D Working Group has highlighted the lack of a gold standard for assessing key aspects of reintegration, as well as the need for assessing patient-centered perspectives on treatment preferences and goals for recovery related to reintegration. An upstream approach focused on early detection, in-depth understanding, and ultimately, effective means of supporting injured OEF/OIF/OND Veterans experiencing reintegration difficulties will result in improved rehabilitation and quality of life outcomes. Objectives: This career development award proposal aims to understand how OEF/OIF/OND Veterans with invisible injuries navigate military to civilian reintegration. The mentoring and training plans extend the candidate's expertise in qualitative methods through instruction in mixed-methods approaches, rehabilitation interventions, and knowledge of evidence-based treatment of invisible injuries. Methods: Utilizing a longitudinal mixed methods approach, this project will investigate complex reintegration processes and associated outcomes through rapid ethnographic inquiry, a prospective cohort study and process mapping. For Aim 1, we will explore how Veterans with invisible injuries experience the initial phase of transition from military service through rapid ethnographic assessment of Veteran outreach events and VA post-deployment health assessments. In Aim 2, 60 Veterans with mental health diagnoses or TBIs and up to 60 care partners (family members, partners, friends, or neighbors), will be recruited as part of a prospective, longitudinal cohort study assessing reintegration, psychosocial experiences, quality of life outcomes, and rehabilitation for two years following separation. For Aim 3, we will partner with Veterans, community and family stakeholders, and VA clinicians to identify strategies and unmet needs to support Veterans experiencing reintegration challenges. An expert panel comprised of Veterans and other key stakeholders will use a community-based participatory research (CBPR) approach and “intervention mapping,...

Key facts

NIH application ID
10264822
Project number
5IK2RX002642-04
Recipient
RLR VA MEDICAL CENTER
Principal Investigator
Nicholas Rattray
Activity code
IK2
Funding institute
VA
Fiscal year
2022
Award amount
Award type
5
Project period
2018-10-01 → 2023-09-30