Race/Ethnicity and Retention in Traumatic Brain Injury Outcomes Research: A Traumatic Brain Injury Model Systems National Database Study.
Angelle M Sander, Anthony H Lequerica, Jessica M Ketchum and 6 others
PMID 29863614WHAT IT FOUND
Retention in 1- and 2-year research follow-up was 85.2% for Hispanic participants, compared with 91.8% for white and 90.5% for black participants.
Preinjury problem substance use altered the pattern, with no race/ethnicity differences among those with such a history.
Key findings
01Retention rates were 91.8% for white participants, 90.5% for black participants, and 85.2% for Hispanic participants.
02In unadjusted analysis, white participants had 1.9 times greater odds of retention than Hispanic participants, black participants had 1.7 times greater odds than Hispanic participants, and white and black participants did not differ.
03Preinjury problem substance use interacted with race/ethnicity: without it, white participants had 2.09 times greater odds and black participants had 2.45 times greater odds of retention than Hispanic participants; with it, no race/ethnicity differences remained.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study was limited to people who received inpatient rehabilitation through the TBIMS system and had mostly moderate to severe TBI, so it may not apply to people with mild TBI, veterans with TBI, or people who did not receive inpatient rehabilitation. The analysis used only variables available in the database, and environmental or social factors that may influence retention were not measured. Race and ethnicity were coded as one mixed variable, so white Hispanic and black Hispanic participants could not be distinguished. Participants coded as Asian/Pacific Islander, Native American, other, or unknown were excluded because their numbers were too small, so the study does not describe retention for those groups. Retention was defined as completing at least 1 question on a 1-year or 2-year follow-up interview, not as full participation in all research contacts. The paper reports 7685 database participants and 348 excluded for other race/ethnicity, but it does not state the final number analysed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that Hispanic patients are less likely to engage with TBI rehabilitation. This study measured retention in research follow-up, not clinical participation or recovery. The lower Hispanic retention was seen overall, but it was not seen among participants with a preinjury history of problem substance use.