Abstract
Objective: To investigate the contribution of preinjury differences and potential biases in outcome measurement in explaining outcome differences between white and African American persons with moderate and severe traumatic brain injury (TBI).
Design: Prospective, 2 group longitudinal study with retrospective self-assessment of preinjury status.
Setting: Inpatient and outpatient TBI rehabilitation program.
Participants: Ninety-four persons with moderate and severe TBI (55 whites and 39 African Americans) who provided data on both preinjury status and 1-year outcome.
Measures: Community Integration Questionnaire, aggression and depression subscales of Neurobehavioral Functioning Inventory-Revised, Satisfaction With Life Scale, other questions on demographic and social status; all measures were selected by a biracial focus group.
Results: Whites and African Americans did not differ significantly on demographic factors except gender; nor on retrospective, self-reported preinjury status on any of the outcome measures. At 1 year post-TBI, African Americans reported significantly lower social integration subscale scores than whites. African Americans may also have lost more income than did whites. All other outcome measures were comparable between groups and showed declines in community productivity, increases in depression symptoms, and lower satisfaction with life for both whites and African Americans compared to preinjury. A higher rate of change in living situation post-TBI may partially account for lower levels of social integration for African Americans.
Conclusion: Whites and African Americans who are comparable prior to injury may experience generally similar outcomes, but differences in social and financial outcomes require further investigation.