# Rehabilitation of Executive Function in Aging Veterans with History of TBI

> **NIH VA IK2** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2023 · —

## Abstract

The goal of this project is to investigate the feasibility and acceptability of using technology to implement home-
based executive function training for aging Veterans with history of traumatic brain injury (TBI).
Background: Problems with attention and executive control are some of the most common sequelae of TBI,
and these areas of cognition are also known to be vulnerable to aging. Goal Oriented Attentional Self-
Regulation (GOALS) is a manualized cognitive training intervention for problems with attention and executive
control that has been shown to improve cognitive, emotional, and functional outcomes in civilians and Veterans
with history of TBI, including Veterans 65 and older, and healthy older adults.
Relevance and significance to Veteran’s health: TBI is prevalent among Veterans. Home-based telehealth
(HBT) may be an effective tool to address lack of access to health care for aging Veterans.
Aim 1: Complete adaptation of the IP-GOALS protocol for a) HBT use and b) use with older Veterans via
collection of feedback from [n=8] Veterans 65+ with history of TBI and cognitive complaints. Aim 2: Examine
the feasibility (defined as recruitment yield, dropout after randomization, retention, and adherence) and
participant-rated acceptability of [IP and] HBT-GOALS in n=36 Veterans 65+ with history of TBI and cognitive
complaints. Hypothesis 2: Feasibility will be demonstrated by achieving targeted recruitment goals with
reasonable rates of dropout after randomization, retention, and adherence, and high levels of participant-rated
acceptability in both groups. Aim 3: Estimate effect sizes for [HBT-GOALS and IP-GOALS using a double-
baseline control] on improving a) cognitive performance and self-reported b) emotional regulation and c) daily
functioning in the same Aim 2 study cohort to inform sample size requirements for a future clinical trial.
Hypothesis 3: Effect size estimates will provide evidence of clinically meaningful improvement on a) cognitive
functioning (Attention and Executive Function Composite), b) emotional regulation (Profile of Mood States
Total Mood Disturbance Score), and c) daily functioning outcomes (Mayo-Portland Adaptability Inventory Total
Score). Exploratory analysis a) will examine whether Veteran characteristics (e.g., age, sex, family/caregiver
support, distance to nearest clinic, and health/mobility issues including chronic pain) are associated with
differences in participant-rated acceptability and feasibility (i.e., recruitment yield, dropout after randomization,
retention and adherence), and [response to IP/HBT-GOALS vs. double baseline control.] Exploratory
analysis b) will examine distribution of responses to select criteria to define responders in future studies.
Methods: Adaptation phase (Aim 1): Adaptation of the existing GOALS protocol for a) HBT use and b) use
with older Veterans will be completed by collecting post-training feasibility and acceptability data. Pilot phase
(Aims 2 and 3 and Exploratory Anal...

## Key facts

- **NIH application ID:** 10543045
- **Project number:** 5IK2RX003073-04
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** Erica S Kornblith
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2023
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2019-12-01 → 2025-03-08

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10543045

## Citation

> US National Institutes of Health, RePORTER application 10543045, Rehabilitation of Executive Function in Aging Veterans with History of TBI (5IK2RX003073-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10543045. Licensed CC0.

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