Effect of School Services on Academic Performance After Traumatic Brain Injury in Hispanic and Non-Hispanic Students

Exploring racial disparities and inequalities among children and youth with acquired brain injury: a systematic review

PURPOSE

Racial minoritized children and youth with acquired brain injury (ABI) often experience multiple forms of discrimination. The purpose of this systematic review was to understand the racial disparities in health care among children and youth with ABI and their caregivers.

METHOD

Six international databases (Ovid Medline, Embase, Healthstar, Psychinfo, Scopus, and Web of Science) were systematically searched for peer-reviewed articles. Studies were screened by two researchers who also conducted the data extraction and quality appraisal. A narrative synthesis approach was used to analyze the data.

RESULTS

Of the 8081 studies identified in the search, 34 met the inclusion criteria, which involved 838,052 children and youth with brain injuries (or caregivers representing them) across two countries. The following themes were noted in the studies in our review: (1) racial disparities in accessing care (i.e., diagnosis, hospital admission, length of stay, rehabilitation treatment); (2) racial disparities in ABI-related health outcomes (i.e., functional outcomes and mortality rates); and (3) factors affecting racial disparities (i.e., sources in injury, insurance and expenditures, and intersectionality).

CONCLUSIONS

Our findings reveal the concerning racial disparities among children and youth with ABI. Further research should explore solutions for addressing such racial disparities and solutions to address them.

Delivering concussion education to pre-service teachers through the SCHOOLFirst website: Evaluating usability and satisfaction

BACKGROUND

Return-to-school processes indicate 'when' to initiate activities and 'what' activities should be accomplished, but are missing 'how' to implement the process. The SCHOOLFirst website provides the 'how' through building concussion knowledge, creating a supportive culture and defining roles. Due to the involvement of pre-service teachers in schools during training and imminent transition to becoming teachers, it is important that pre-service teachers are trained in concussion and can optimally support current and future students.

OBJECTIVE

To determine: 1) pre-service teachers' knowledge and confidence surrounding the return-to-school process before and after using the SCHOOLFirst website; 2) the usability, intended use and satisfaction of the SCHOOLFirst website from the perspective of pre-service teachers.

METHODS

Thirty pre-service teachers completed the demographic survey, knowledge and confidence survey, System Usability Scale, and satisfaction and intended use survey after participating in a workshop.

RESULTS

Significant increases in concussion knowledge (Z = -4.093, p <  0.001) and confidence in helping students return-to-school (Z = -4.620, p <  0.001) were measured after using the SCHOOLFirst website. Participants were satisfied with the SCHOOLFirst website (93.4%) and intend to use it in the future when supporting a student post-concussion (96.4%).

CONCLUSION

The SCHOOLFirst website is a valuable tool for pre-service teachers to support students' return-to-school post-concussion.

The role of social determinants of health in the receipt of school services after\\ traumatic brain injury: A focus review on underserved pediatric populations

BACKGROUND

Return to school is key for community re-integration after a traumatic brain injury (TBI). School support facilitates and ensure a successful transition back to school. However, access to school services is not uniform among U.S. children.

OBJECTIVE

To describe school services for children with TBI from minoritized backgrounds and highlight population-specific risk factors and facilitators for accessing services.

METHODS

Narrative review of the literature including studies on return to school after a mild-complicated, moderate, or severe TBI, among children enrolled in the U.S. school system. We describe receipt of services, enabling and risk factors, and outcomes, for minority children.

RESULTS

There is a gap in knowledge regarding return to school among minoritized children with TBIs. Studies have few participants from racial and ethnic minority backgrounds, or low income or rural communities. Transgender and non-binary youth are not represented in present research efforts. Studies highlight larger barriers to receipt of school services among minority children and additional barriers associated with their minority status.

CONCLUSION

Diversity in the U.S pediatric population is increasing. Minoritized populations are at increased risk for TBI and poor outcomes. Research focused on the needs of these populations is required to optimize school return after TBI hospitalization and overall post-discharge care.

Exploring the relationships between race, ethnicity, and school and work outcomes among youth and young adults with disabilities: a scoping review

PURPOSE

Youth with disabilities often encounter barriers in finding meaningful employment and completing post-secondary education. Such challenges are often even more profound for youth who identify as an ethnic minority. The purpose of this study was to understand the relationships between race, ethnicity and school and work outcomes for youth with disabilities.

METHODS

We conducted a scoping review while searching eight international databases that identified 49 studies meeting our inclusion criteria.

RESULTS

Of the 49 studies that were included in the review, they involved youth and young adults with disabilities (aged 6-29) over a 21-year period. The majority of the studies focusing on school showed that ethnic minority youth with disabilities had poorer school outcomes compared to white youth with disabilities. Meanwhile, most studies focusing on work reported that ethnic minority youth with a disability had worse employment outcomes compared to white disabled youth. Factors influencing school and work included cultural differences in expectations, inequitable access to services and resources, and discrimination.

CONCLUSIONS

Our findings highlight the disparities that exist for young people with disabilities from ethnic minority backgrounds. There is an urgent need for further research to understand their lived experiences to help address gaps in school and work outcomes.Implications for rehabilitationClinicians and educators should help to provide ethnic minority youth with equitable resources and opportunities to help them achieve their school and career goals.Clinicians and educators should consider participating in culturally sensitive care training to better understand the different needs and experiences of ethnic minority youth with disabilities.Clinicians and educators should try to work collectively with parents and ethnic minority youth with disabilities to optimize their transition outcomes.

Factors Related to Concussion Knowledge, Attitudes, and Reporting Behaviors in US High School Athletes: A Systematic Review

BACKGROUND

Sport-related concussions are a major public health problem with only 50% of concussed teens reporting their symptoms. The purpose of this systematic review was to identify individual and institutional factors that contribute to concussion knowledge, attitude, and reporting behaviors among US high school athletes.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol was used to direct the process of this systematic review. A search for English, peer-reviewed, quantitative studies published between 2010 and 2020 was conducted in 5 scholarly databases. The Joanna Briggs Critical Appraisal Tools were used to assess study quality.

RESULTS

Twenty-two studies met criteria for inclusion in this systematic review. The study designs were mostly cross-sectional (N = 18). Synthesis revealed individual factors including gender, age, race/ethnicity, grade level, and concussion history were associated with differences in concussion knowledge, attitude, and/or reporting behaviors. Institutional factors identified included school location, concussion education, access to an athletic trainer, sport played, and team climate. Six studies found concussion education had a positive impact on knowledge and reporting behaviors.

CONCLUSION

This systematic review identified certain populations which may be more vulnerable to underreporting concussion symptoms; therefore, a targeted approach to education and management may be more effective.

Understanding the Needs of Ontario Educators in Supporting Students With Acquired Brain Injury in the Classroom

BACKGROUND

When a child sustains an acquired brain injury (ABI), the impact extends to significant environments in their life, including school. Educator knowledge of ABI can influence a child's success with academic and social reintegration. An assessment of educator ABI knowledge was conducted to determine what information they require to support school reintegration.

METHODS

A mixed-methods approach included a sampling of educators in a needs assessment survey and workshop. The survey determined levels of educator knowledge regarding ABI in the classroom, and the workshop scoped educator views in the development of a user-driven ABI learning program to enrich their expertise.

RESULTS

Our sample reported being somewhat knowledgeable about ABI and the impact on students. There were no differences based on respondents' educational role. Teachers reported having minimal and inadequate supports for students following ABI during school transitions, feeling unprepared to assist students during these transitions, and that families also appeared unprepared for school reintegration following ABI. The workshop identified the need for a 2-part educational course.

CONCLUSIONS

Supportive school environments are essential for the reintegration of students following ABI. This study identified educators' needs for ABI knowledge and resources to support their existing expertise.