Oyesanya Submits Duke REACH Equity Investigator Development Award Application

Kudos to Tolu Oyesanya, assistant professor, and her entire team for the submission of her Duke REACH Equity Investigator Development Award application entitled “Reducing Disparities in the Transition from Hospital to Home for Black Patients with TBI & Families." This proposal request funding for a two-year period with a start date of Feb. 1, 2019.

The consequences of traumatic brain injury (TBI) disproportionately affect black communities across the nation. Black young adults with moderate-to-severe TBI (age 18-35) who are discharged home from acute hospital care are more likely to have cognitive, physical, behavioral, and emotional impairments that affect their abilities to independently self-manage their health, wellness, and activities of daily living than whites. This limited independence often results in increased family involvement in managing the person’s care. In addition, after discharge home, black young adults with TBI have higher rates of depression, worse functional outcomes, and are less likely to return to work than whites. Research in other patient populations points to several potential contributors to disparities that may be at play for black young adults with TBI and their families, including social determinants of health related to socioeconomic status and healthcare access, issues with interpersonal processes of care, and patient/family mistrust of the health system. Yet, there is limited research on contributors to disparities in the healthcare transition process and on strategies to support black young adults with TBI and their families as they transition home from the hospital. The research proposed in this REACH CDA will address these gaps in knowledge. The purpose of this study is to first identify barriers and facilitators to high quality care in the transition home from acute hospital care that are perceived to contribute to disparities in post-acute outcomes from the perspectives of black young adults with TBI, their families, and healthcare providers. Second, we will use this essential knowledge to direct development and testing of a culturally sensitive, patient- and family-centered transitional care intervention for black young adults with TBI and their families. Findings will inform future testing of intervention efficacy and implementation-effectiveness.