Demographic Associations with Multidimensional Health Perceptions After Traumatic Brain Injury (TBI): A TBI Model Systems Study

Research Objectives: To investigate demographic (i.e., race, ethnicity, gender identity, and age) differences in health perceptions among individuals with traumatic brain injury (TBI).

Design: A multisite survey study across five TBI Model Systems centers.

Setting: Community.

Participants: 198 individuals at least one-year post TBI [mean age=46.44; predominantly non-Hispanic White (68.4%); 68.7% cisgender male, 30.3% cisgender female, 1% transgender/non-binary/other) who completed the Multidimensional Health Perceptions Questionnaire (MHPQ).

Interventions: N/A.

Main Outcome Measures: The MHPQ, which is comprised of 65 items rated on a 1-5 ordinal agreement scale (1 = strongly disagree to 5 = strongly agree), yields 7 average subscales scores: Anticipated Discrimination and Judgement, Spiritual Health Beliefs, Social and Emotional Well-Being Beliefs, Confidence and Trust in Healthcare Providers and Medicine, Health Self-Efficacy, Trust in Social Health Advice, and Health Literacy.

Results: Separate ANOVAs revealed no significant differences between race (White, Black, Native/Indigenous, Multiracial, and Other), race-ethnicity combined (non-Hispanic White, Black, Hispanic (all races), Multiracial, and Other/Unknown), age (Transition-aged adults, Early Adulthood, Middle Adulthood, and Older Adulthood), and gender identity (cisgender male, cisgender female, transgender/non-binary/other) across all 7 subscales of the MHPQ. Though demographic groups did not differ statistically, there was a range of scores across all subscales indicating large variability in individual differences in health perceptions (mean, SD, range): Anticipated Discrimination and Judgement=2.08, 0.61, 1.00-4.07; Spiritual Health Beliefs=3.00, 0.71, 1.18-4.64; Social and Emotional Well-Being Beliefs=3.59, 0.56, 1.44-4.89; Confidence and Trust in Healthcare Providers and Medicine=3.67, 0.43, 2.73-5.00; Health Self-Efficacy=3.90, 0.50, 2.38-5.00; Trust in Social Health Advice=2.63, 0.67, 1.00-5.00; and Health Literacy=4.12, 0.54, 2.17-5.00.

Conclusions: Beliefs and perceptions about health are crucial to healthcare engagement and outcomes. Understanding these perceptions, particularly among individuals with TBI, is essential for tailoring effective interventions and communication strategies. Our findings suggest that health perceptions are not directly linked with demographic factors but do vary across individuals. These findings emphasize the importance of enhancing person-centered, culturally competent healthcare delivery to individuals with TBI.

Author(s) Disclosures: Funded by NIDILRR grant numbers 90DPTB0023, 90DPTB0019, 90DPTB0027, 90DPTB0025, 90DPTB0022. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this abstract do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.