Welcome to today’s webinar for ACL Grantees! Before we begin today’s webinar…a few housekeeping items: First, we would like to Thank you for attending! Please double check to make sure your microphone is on mute and your speakers are working (see “Audio Operations” to open the “audio settings” window). This webinar will last 1 hour, and will conclude with time left for a Question & Answer period. You may click the “Q&A” window on your screen at anytime during the webinar to type in your question (be sure to click “Send”). All questions will answered in order received. Webinars will be recorded for later viewing. For troubleshooting: email [email protected]
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Welcome to today’s webinar for ACL Grantees!...Before we begin today’s webinar…a few housekeeping items: First, we would like to Thank you for attending! Please double check
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Transcript
Welcome to today’s webinar for
ACL Grantees!
Before we begin today’s webinar…a few housekeeping items:
First, we would like to Thank you for attending!
Please double check to make sure your microphone is on
mute and your speakers are working (see “Audio Operations”
to open the “audio settings” window).
This webinar will last 1 hour, and will conclude with time left
for a Question & Answer period. You may click the “Q&A”
window on your screen at anytime during the webinar to type
in your question (be sure to click “Send”). All questions will
"I think I may need it to have periodic evaluations to determine my level of capacity on a regular basis. Some things have improved and some symptoms have worsened and others are just now beginning to surface. I think that establishing a history of capacity would give a better picture of services needed and other medical tests that may need to be done. This would provide a full range of services that would better serve your clientele."
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Evidence for Resource Facilitation to Manage Outcomes following Chronic TBI
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Resource Facilitation Defined
• Individualized assessment
• Provide brain injury specific education and promote awareness of resources
• Proactive navigation to community-based supports, resources and services
• Remove instrumental barriers (e.g., housing) as well as brain injury-specific barriers (e.g., memory impairment) to successful community re-integration and return to work.
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Resource Facilitation to Manage TBI as A Chronic Condition
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Indiana Resource Facilitation Research Findings for Vocational Outcomes
• RCT 1: 64% return to work rate after 9 months of RF versus 36% for controls (P<.0001)
• RCT 2: RF group return to work/school significantly earlier and more often than controls (P<.027), and
Group assignment was a significant predictor of outcome (P=.027) and the RF group was found to be 7 times more likely to return to work
• Trexler, L.E. & Parrott, D.R (2018). Models of Brain Injury Vocational Rehabilitation: The Evidence for Resource
Facilitation from Efficacy to Effectiveness. Journal of Vocational Rehabilitation, 49(2), 195-203.
• Trexler, LE, Parrott, DR, & Malec, JF (2016). Replication of a Prospective Randomized Controlled Trial for Resource
Facilitation to Improve Return to Work after Brain Injury. Archives of Physical Medicine and Rehabilitation, 97(2), 204-210.
• Trexler, LE, Trexler, LC, Malec, JF, Klyce, D., & Parrott, D. (2010). Prospective randomized controlled trial of resource
facilitation on community participation and vocational outcome following brain injury. Journal of Head Trauma
Rehabilitation, 25(6), 440-446.
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Resource Facilitation and Return to Work
• Prospective Clinical Cohort 1 (n=69):• Subjects referred from Indiana Vocational Rehabilitation
• 9.28 years post-injury
• 67% return to work rate after 9 months of Resource Facilitation versus 18%
• Prospective Clinical Cohort 2 (n=141):• Subjects referred from Indiana Vocational Rehabilitation
• 10.10 years post-injury
• 70% return to work rate after 11.6 months of Resource Facilitation versus 18%
Trexler LE and Parrott, D.R (in press). Models of Brain Injury Vocational Rehabilitation: The Evidence for Resource Facilitation from Efficacy to Effectiveness.
Journal of Vocational Rehabilitation.
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
CENTER FOR BUSINESS AND ECONOMIC RESEARCH Phone: 765-285-5926
MILLER COLLEGE OF BUSINESS Fax: 765-285-8024
February 21, 2017
Economic Impact of Resource
Facilitation:
Workforce Re-entry Following
Traumatic Brain Injury Brandon Patterson, Graduate Research Assistant
Srikant Devaraj, Ph.D., Research Economist and Research Assistant Professor
Michael J. Hicks, Ph.D., George & Frances Ball Distinguished Professor of
Economics, Director of Center for Business and Economic Research
Annual Aggregate Lifetime Economic Impact of Resource Facilitation
• Wages and benefits = $249.1 million
• Revenue from taxes = $30.97 million
• Savings to SSDI/private disability = $80.1 million
• SNAP = $6.6 million
• Total = $366.77 million/year
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Other Non-Vocational Research Findings
for Resource Facilitation
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Activities of Daily Living Scale
• Self Care Activities
• Household Care
• Employment and Recreation
• Shopping and Money Management
• Travel
• Communication
• Total
Results demonstrated a statistically
significant decrease in the reported
amount of assistance required to
complete activities of daily living
after RF (t=5.35, p=.000).
•Johnson, N., Barion, A., Rademaker, A., Rehkemper, G., & Weintraub, S. (2004). The
Activities of Daily Living Questionnaire: a validation study in patients with dementia.
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Mayo-Portland Adaptability Inventory
MPAI-4 results show a significant (t=4. 07, p=.000). decline in level of disability across all subscales:
• abilities (e.g., mobility, memory),
• adjustment (e.g., depression social interaction), and
• participation (e.g., managing money, transportation) after RF
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Survey of Unmet Needs and Service Use
Heinemann, A.W. et al. (2002). Measuring unmet needs and services among persons with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 83, 2052-1059
• Developed specifically for brain injury
• Variety of instrumental and service needs
• Addresses both what they are receiving and perceived needs
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Survey of Unmet Needs
• Number of services used declined significantly from baseline to discharge (t=2.83, p=.005).
• Desired services declined significantly from baseline to discharge (t=13.53, p=.000).
• Examples of needs that were met through RF:
• controlling alcohol and/or drug use,
• increasing independence in eating, dressing, and bathing, and
• finding housing that is affordable and accessible.
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
TBI, Resource Facilitation and Re-Arrest: New Findings
Recidivism for Offenders:
• With TBI = 24.2%
• Without TBI = 17.7%
RF Findings:
• 195 offenders with TBI, 31 of whom got RF.
• 10% re-offended who got RF.
• 25.6% of the control group re-offended.
• Offenders with TBI who did not get RF were found to have a risk for re-offending of over two and a half times greater than those who got RF (RR =2.64)
• RF can cut the risk of re-offending by 60% (25.6% vs 10%)
Trexler LE & Parrott DR (in preparation). Resource Facilitation and
the Prevention of Re-Incarceration in People with TBI.
Z=2.05,
p=0.02
Z=1.93,
p=0.027
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Conclusions
• Resource Facilitation significantly improves return to
work and school for acute and chronic TBI
• These effects result in a significant economic benefit
• Preliminary data suggests that Resource Facilitation may
• Reduce level of disability in chronic TBI
• Reduce services used and desired services
• Reduce recidivism
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
Utilization of BEAM in a Randomized
Controlled Trial of Resource Facilitation
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020
BEAM/MyBRAIN
• Clinical Individual and Cohort Purpose:• Surveillance
• Assessment and Re-Assessment
• Risk Stratification
• Intensity and Type of Resource Facilitation Follow-up
• Self-Management Training
• Use data for research on • Predictors of recovery – stability – decline
• Effectiveness of treatment
ACL Mentor State Webinar Series on Resource Facilitation | Indiana | RF as a Model to Manage TBI as a Chronic Condition | Mar 31 2020