Culture Shift Within the Department of Defense Regarding Brain Injury Detection and Treatment

Research Objectives: To identify facilitators and barriers to implementing policy within the Department of Defense (DOD).

Design: Five DOD stakeholders participated in individual qualitative interviews and were recruited through presentations, emails, and snowball sampling. The interviews were conducted by two trained interviewers using a semi-structured interview script. The interviews were audio recorded and transcribed for analysis. Analysis was conducted using grounded theory then organized into themes.

Setting: Research activities were conducted in-person at the James A. Haley VA in Tampa, FL and virtually through Microsoft Teams.

Participants: Participants were administrative stakeholders from the Department of Defense.

Interventions: No intervention was utilized.

Main Outcome Measures: Demographic survey and semi-structured qualitative interviews.

Results: Based on interview findings, the DOD has developed organizational goals related to changing the culture of the military regarding service member brain injury (reducing stigma associated with reporting injury and seeking care), ensuring consistent services across regions, and providing appropriate education and training across the operational and medical specialties within the military. Facilitators to supporting change included implementing policies, leadership buy-in, leveraging partnerships with operational and research communities, stakeholders, and families, changing language to reduce stigma, education, and training. However, implementing change is not without barriers. Participants listed several barriers to implementing change including inability to monitor implementation of policies, leadership changes, lack of buy-in, translating research into practice, overlap and confusion regarding new policies and existing policies, lack of standardized care, and staffing shortages.

Conclusions: Policy implementation within the DOD has supported a cultural shift in how service member brain injury is recognized and treated. The findings suggest a continued need for strategies to ensure effective policy implementation.

Author(s) Disclosures: The authors have no disclosures to report. The views expressed in this abstract are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. For more information, please contact dha.TBICOEinfo@health.mil.