Project Description / Abstract: My long-term career goal is to improve caregiver and patient dyad outcomes by developing family- centered psychosocial interventions that enhance education, support, and skill-building in caregivers of moderate to severe traumatic brain injury (msTBI) survivors. The training activities in my K23 proposal include: (1) mentored experiential learning; (2) seminars, workshops, and conferences; (3) didactic coursework; and (4) skills developed by completing the study aims. Training will be overseen by my Primary Mentor (Opeolu Adeoye, University of Cincinnati (UC)), and Co-Mentors (Tamilyn Bakas, UC; Shari Wade, UC; Brad Kurowski, UC). Additional training will be obtained by working with Collaborators (Heidi Sucharew and Paula Shear, UC; and Carrie Collier, Bowen Family Systems Theory Research Group). My research will test Caregiver Wellness after TBI (CG-Well), a skill-building, education, and support intervention I have developed. I will be prepared to submit an R01 for a large Phase III clinical trial at the completion of the K23 award. After injury, survivors of msTBI depend on informal family caregivers. Upwards of 77% of family caregivers experience poor outcomes, such as adverse life changes, poor health related quality of life, and increased depressive symptoms. Caregivers frequently report minimal support or training to prepare them for their new role. Periods of care transitions, such as ICU discharge, are most difficult. The majority (93%) of previously developed caregiver and caregiver/survivor dyad interventions after msTBI focus on providing information or practical skills to either survivors, or to long-term caregivers (>6 months post injury), rather than education, support, and skill-building that the new caregiver may use proactively that will benefit the dyad acutely after injury. The Aims of this proposal are to: (1) Determine feasibility, satisfaction, and data trends of CG-Well; and (2) Understand how baseline psychosocial risk factors affect response to CG-Well compared to an Information, Support, and Referral control group. To accomplish this, I will first enroll 6-10 caregivers and tailor CG-well until each finds the intervention acceptable, appropriate, and feasible. I will then enroll 100 (50/group) dyads and determine satisfaction ratings, recruitment, retention, and treatment fidelity of CG-Well. Additionally, I will determine if caregivers report reductions in depressive symptoms and improvements in life changes as a result of improvements in task difficulty and threat appraisal in CG-Well compared to ISR at six months. Information obtained in Aims 1 and 2 will be used to plan a larger Phase III trial of CG-Well. Completing these Aims and the training plan will improve outcomes of caregivers and downstream outcomes of survivors of msTBI, and provide me with the skillset necessary to become an independent researcher who can develop and test high-impact, high-fidelity, sustainable interventions.

Project Narrative: Up to 5.3 million people in the U.S. live with long-term disabilities after traumatic brain injury (TBI), and patients with moderate and severe TBI have the highest acute, subacute, and long-term need for resources. Untrained friends and family members often assume caregiving responsibilities; however, few are prepared to do so, and caregivers subsequently experience problems with depression, health, and poor life changes as a result of caregiving. The goal of this study is to determine if early involvement of the caregiver acutely after adult TBI with a novel online intervention, CG-Well, is feasible, acceptable, and associated with improved caregiver wellbeing compared to a control group.