ENGAGE-TBI: adaptation of a community-based intervention to improve social participation after brain injury.

Only six people took part in the pilot, and it was a single-group pre-post study, so outcome changes cannot show the programme caused them. The protocol was changed during the study, so the results cannot be attributed to the final ENGAGE-TBI programme. Change scores varied widely across the six participants. One pilot participant did not complete additional study activities, and the authors included that person in retention but not in other feasibility analyses. The study took place at one community day programme where participants already attended regularly, so attendance and retention may not apply elsewhere. Participants knew the research team, which may have influenced their responses. People with severe communication impairment that would limit a verbal group were excluded. Fidelity to the final protocol was not tested. One peer mentor required significant ongoing support, so peer mentor selection and training are not solved by the final protocol.

Do not read the participation and mental health changes as proof that ENGAGE-TBI works. It was a six-person single-group pilot of a multi-component programme, and the protocol was still being adapted, so the authors say changes cannot be attributed to the final programme.