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. 2025 Jan;106(1):145-149.
doi: 10.1016/j.apmr.2024.08.001. Epub 2024 Aug 21.

Model of Care for Chronic Brain Injury

John D Corrigan  1 , Flora M Hammond  2 , Angelle M Sander  3 , Kurt Kroenke  4
Affiliations

Model of Care for Chronic Brain Injury

John D Corrigan et al. Arch Phys Med Rehabil. 2025 Jan.

Abstract

There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition. In 2020, the National Institute on Disability Independent Living and Rehabilitation Research funded the BeHEALTHY project to develop a model for long-term support of persons with chronic brain injury. Based on initial reviews of the available evidence and expert input from researchers, clinicians, and persons with lived experience, the BeHEALTHY model was proposed. Among existing chronic disease treatment models, Wagner's Chronic Care Model was selected as a starting point, with several critical refinements. The BeHEALTHY model endorses a person-centered approach, recognizing the individual with brain injury, and their social support system, as the primary source of goals in care planning. The model also acknowledges the critical importance of self-management and the need for health care programs to actively promote self-direction by the person using their social supports. The model also recognizes that outcomes are not determined solely by the person and the injury incurred but also by the environment in which a person lives and recovers. The importance of integrating health care with community resources is underscored by embracing environmental influences as a shared responsibility of the community and the health care system. This article recounts the impetus for developing the BeHEALTHY model and describes those it is intended to serve and its structural features and core components.

Keywords: Chronic health condition; Disease management; Rehabilitation; Traumatic brain injury.

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Figures

Fig 1
Fig 1
Change in the Glasgow Outcome Scale-Extended (GOS-E) between 2 successive follow-up interviews.
Fig 2
Fig 2
BeHEALTHY model for self-directed management of chronic brain injury.
See this image and copyright information in PMC

References

    1. Corrigan JD, Hammond FM. Traumatic brain injury as a chronic health condition. Arch Phys Med Rehabil 2013;94:1199–201. - PubMed
    1. Masel BE, DeWitt DS. Traumatic brain injury: a disease process, not an event. J Neurotrauma 2010;27:1529–40. - PubMed
    1. US Institute of Medicine Committee on Gulf War and Health: Brain Injury in Veterans and Long-Term Health Outcomes. Gulf War and Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury. Washington, DC: National Academies Press; 2008. - PubMed
    1. Malec JF, Hammond FM, Flanagan S, Kean J, Sander A, Sherer M, et al. Recommendations from the 2013 Galveston Brain Injury Conference for implementation of a chronic care model in brain injury. J Head Trauma Rehabil 2013;28:476–83. - PubMed
    1. Brain Injury Canada and Canadian Traumatic Brain Injury Research Consortium. Moderate and Severe Traumatic Brain Injury as a Chronic Condition. 2023. Available at: https://braininjurycanada.ca/en/tbi-position-paper/https://braininjuryca.... Accessed February 17, 2024.

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