Improving rehabilitation care for traumatic brain injury patients with community health services

Improving Traumatic Brain Injury Rehabilitation Care Transitions With Community Health Services: A Randomized Clinical Trial (CHW Intervention for TBI Care Transitions [CHWI for TBI]), a Research Project Within the TBI Model System

Early Phase 1 Interventional Virginia Commonwealth University · NCT06188364

This study is testing if adding community health workers to help support people with traumatic brain injury and their families can make their transition from hospital to home easier and improve their recovery.

Quick facts

PhaseEarly Phase 1
Study typeInterventional
Enrollment126 (estimated)
Ages18 Years and up
SexAll
SponsorVirginia Commonwealth University Academic / other
Locations1 site (Richmond, Virginia)
Trial IDNCT06188364 on ClinicalTrials.gov

What this trial studies

This project focuses on enhancing the rehabilitation care transitions for individuals with traumatic brain injury (TBI) by integrating community health services. It aims to support patients and their caregivers as they move from inpatient rehabilitation to home or other care settings. The study will utilize community health workers to provide care coordination, advocacy, and direct support, addressing the unique challenges faced by TBI patients and their families, particularly those from underserved backgrounds. The intervention includes standard care alongside experimental approaches to improve the overall care experience and outcomes.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18 or older who are primary caregivers for individuals with TBI recently discharged from inpatient rehabilitation.

Not a fit: Patients with severe cognitive impairments that prevent them from providing informed consent or functioning safely as caregivers will not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could significantly improve the quality of life and independence for patients recovering from traumatic brain injury.

How similar studies have performed: Other studies have shown promise in using community health workers to support rehabilitation transitions, indicating potential for success in this approach.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Participants must be adults (age 18 or older).
* Must be primary person responsible for supervision/care needs of person with TBI post-IRF discharge.
* The person with TBI must have been admitted to the Brain Injury Service Unit at SAI.
* If the care partner does not live in the same residence as the person with TBI, they must provide multiple daily check-ins on day-to-day care.
* Must agree to use mHealth (texts, calls) and possess or be eligible to acquire a smart phone.

Exclusion Criteria:

* Any severe cognitive impairment that precludes the ability to provide informed consent or safely function as the care partner for a vulnerable adult with TBI.

Where this trial is running

Richmond, Virginia

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Traumatic Brain InjuryCommunity Health ServicesRehabilitation Care TransitionsCaregiver Supports
Last reviewed 2026-06-10 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.