Christina Dillahunt-Aspillaga

Research Article in Rehabilitation Education The Application of Artificial Intelligence in Case Management, Vocational Rehabilitation, and Life Care Planning: Ethical Considerations and Practice Implications Dillahunt-Aspillaga, Christina Rehabilitation Education , Sep 2025, DOI: 10.1891/RE-25-32 Focus Article Metrics Article usage Article Usage Period Abstract Full PDF Total Oct 2025 1 0 1 2 Cited by Crossref Google Scholar Focus

Background: Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service. Objective: Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration’s Health Service Research and Development Service. The goal of ENCORE is to maximize veteran and family reintegration by promoting innovative research and knowledge translation (KT) that informs and improves equitable Department of Veterans Affairs (VA) policies, programs, and services. Overall, 2 strategic objectives guide ENCORE activities: mobilize veteran CR research and promote innovation, relevance, and acceleration of veteran CR research and KT. Methods: ENCORE uses a mixed methods and stakeholder-engaged approach to achieve objectives and to ensure that the KT products generated are inclusive, innovative, and meaningful to stakeholders. Project activities will occur over 5 years (2019-2024) in 5 phases: plan, engage, mobilize, promote, and evaluate. All activities will be conducted remotely owing to the ongoing COVID-19 pandemic. Methods used will include reviewing research funding and literature examining the gaps in veteran CR research, conducting expert informant interviews with VA program office representatives, and assembling and working with a Multistakeholder Partnership (MSP). MSP meetings will use external facilitation services, group facilitation techniques adapted for virtual settings, and a 6-step group facilitation process to ensure successful execution of meetings and accomplishment of goals. Results: As of December 2022, data collection for ENCORE is ongoing, with the team completing interviews with 20 stakeholders from 16 VA program offices providing veteran CR–related services. ENCORE developed and assembled the MSP, reviewed the VA funding portfolio and veteran CR research literature, and conducted a scientific gap analysis. The MSP developed a veteran CR research agenda in 2021 and continues to work with the ENCORE team to prepare materials for dissemination. Conclusions: The goal of this program is to improve the impact of veteran CR research on policies and programs. Using a stakeholder-engaged process, insights from key stakeholder groups are being incorporated to set a research agenda that is more likely to result in a relevant and responsive veteran CR research program. Future products will include the development of an effective and relevant dissemination plan and the generation of innovative and relevant dissemination products designed for rapid KT. International Registered Report Identifier (IRRID): DERR1-10.2196/42029

BACKGROUND Veteran community reintegration (CR) has been defined as participation in community life, including employment or other productive activities, independent living, and social relationships. Veteran CR is a Veterans Health Administration priority, as a substantial proportion of veterans report difficulties with veteran CR following discharge from military service. OBJECTIVE Enhancing Veteran Community Reintegration Research (ENCORE) is a project funded by Veterans Health Administration’s Health Service Research and Development Service. The goal of ENCORE is to maximize veteran and family reintegration by promoting innovative research and knowledge translation (KT) that informs and improves equitable Department of Veterans Affairs (VA) policies, programs, and services. Overall, 2 strategic objectives guide ENCORE activities: mobilize veteran CR research and promote innovation, relevance, and acceleration of veteran CR research and KT. METHODS ENCORE uses a mixed methods and stakeholder-engaged approach to achieve objectives and to ensure that the KT products generated are inclusive, innovative, and meaningful to stakeholders. Project activities will occur over 5 years (2019-2024) in 5 phases: plan, engage, mobilize, promote, and evaluate. All activities will be conducted remotely owing to the ongoing COVID-19 pandemic. Methods used will include reviewing research funding and literature examining the gaps in veteran CR research, conducting expert informant interviews with VA program office representatives, and assembling and working with a Multistakeholder Partnership (MSP). MSP meetings will use external facilitation services, group facilitation techniques adapted for virtual settings, and a 6-step group facilitation process to ensure successful execution of meetings and accomplishment of goals. RESULTS As of December 2022, data collection for ENCORE is ongoing, with the team completing interviews with 20 stakeholders from 16 VA program offices providing veteran CR–related services. ENCORE developed and assembled the MSP, reviewed the VA funding portfolio and veteran CR research literature, and conducted a scientific gap analysis. The MSP developed a veteran CR research agenda in 2021 and continues to work with the ENCORE team to prepare materials for dissemination. CONCLUSIONS The goal of this program is to improve the impact of veteran CR research on policies and programs. Using a stakeholder-engaged process, insights from key stakeholder groups are being incorporated to set a research agenda that is more likely to result in a relevant and responsive veteran CR research program. Future products will include the development of an effective and relevant dissemination plan and the generation of innovative and relevant dissemination products designed for rapid KT. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/42029

Veteran communities including veterans, their families, and their caregivers are vital collaborators in the field of veterans studies. Veteran community engaged research (CEnR) generates findings that are impactful and applicable to target populations. Veteran CEnR is a valuable emerging methodological approach. In the two decades since 9/11, clinical and health services researchers have increasingly prioritized participatory veteran research designs. The purpose of this article is to illustrate the important application of veteran CEnR to the development of a US Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) research agenda that tackles a nuanced subject—veteran community reintegration. The Enhancing Veteran Community Reintegration Research (ENCORE) project includes a multi-stakeholder partnership (MSP) that engages veterans, families and caregivers, VA program directors, leaders in veteran community reintegration research, and representatives from community based veteran service organizations. Veteran CEnR was used as an approach to co-author this article with MSP research partners. Contributions from MSP volunteer authors are woven throughout the article to illustrate the organization and functioning of the MSP and impact of this type of stakeholder engagement throughout the project.

To examine return to school outcomes 1 year after traumatic brain injury (TBI) rehabilitation discharge.Longitudinal observational study using Traumatic Brain Injury Model Systems National Database...

To describe the development of the Rehabilitation Needs Survey (RNS) for persons in the chronic phase of traumatic brain injury (TBI) recovery.RNS items were generated following a literature review...

Objective: To examine racial/ethnic disparities in community participation among veterans and active duty service members with traumatic brain injury (TBI). Setting: Five Department of Veterans Affairs (VA) TBI Model Systems (TBIMS) Polytrauma Rehabilitation Centers (PRCs). Participants: Three hundred forty-two community-dwelling adults (251 White, 34 Black, and 57 Hispanic) with TBI enrolled in the VA TBIMS National Database who completed a 1-year follow-up interview. Mean age was 38.6 years (range, 19-84 years). Design: Cross-sectional analysis of a prospective observational cohort study. Main Measures: Community participation at 1 year postinjury assessed by 3 domains of the Participation Assessment with Recombined Tools–Objective (PART-O): Out & About, Productivity, and Social Relations. Results: Significant differences were observed among race/ethnicity groups in PART-O Productivity and Out & About domains without controlling for relevant participant characteristics; Productivity scores were significantly higher for non-Hispanic Black than for non-Hispanic White participants (t = 2.40, P = .0169). Out & About scores were significantly higher for Hispanic than for non-Hispanic White participants (t = 2.79, P = .0056). However, after controlling for demographic, injury severity, and 1-year follow-up characteristics, only differences in the Out & About domain remained statistically significant (t = 2.62, P = .0094), with scores being significantly higher for Hispanics than for non-Hispanic Whites. Conclusions: The results, which differ from findings from studies conducted in non-VA healthcare settings where there are greater racial/ethnic disparities in participation outcomes, could reflect differences between military and civilian samples that may reduce disparities.

Objective: Resource Facilitation is a lesser-known service line within the field of brain injury rehabilitation and has been described as similar to case management, care coordination, and neuronavigation. The purpose of this project was to evaluate current Resource Facilitation programs and provide a comprehensive summary of program characteristics to work toward a common definition of Resource Facilitation services and inform future program development and evaluation frameworks. Materials and Methods: An online survey was sent to all known Resource Facilitation programs in the US (N = 70). Data Collection: Completed through Survey Monkey including information related to program history, structure, population served, and outcomes measurement. StatisticalAnalysis: Descriptive statistical analyses were applied. Results: Twenty-four of the 70 programs completed the survey, resulting in a 34% completion rate. This snapshot of the current definitions and activities demonstrated high variability across programs regarding structure, funding, eligibility, and data collection. Only 33% of programs reported having a program evaluation system. Conclusions: This project provided a comprehensive summary of Resource Facilitation program characteristics and associated outcome metrics. The findings may be used to begin the formulation of a common definition of Resource Facilitation services, a program evaluation framework, and aid in establishing a common data set across programs.

Background: Numerous studies of community reintegration (CR) in traumatic brain injury (TBI) have been conducted in civilian populations, but research is limited in veteran and military service member populations. Little is known about how knowledge from civilian studies translates into veterans’ experiences and needs. The US Department of Veterans Health Administration (VHA) recognizes the distinctive health care needs of post-9/11 veteran and military service members, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to veteran and military service members’ homes and communities to facilitate CR. Objective: The goal of this study is to better understand the experiences of veterans with complicated mild, moderate, or severe TBI; their families; and CR workers as veterans and servicemembers transition to and sustain living in communities. This paper describes the rationale, design, and methods used to reach this goal. Methods: This five-year longitudinal mixed methods study uses both a community-engaged research (CEnR) approach and an ethnographic approach. The sample includes 30 veterans and service members with TBI, 13 family caregivers, 11 CR specialists, 16 key stakeholders, and 82 community events. Interviews and observations are coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis is used to highlight the complex social context of reintegration and to triangulate quantitative data. Egocentric (personal) social network analysis is used to examine the support system a veteran or service member has in place to facilitate reintegration. Results: Study enrollment and data collection are completed. Data analyses are underway. Conclusions: The results of this study may provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate, or severe TBI. Veteran, servicemember and family voices and insights provide VHA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of veterans, military service members, and families. The results of this study provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. The longitudinal ethnographic approach allows for capturing detailed experiences within the naturalistic context. CEnR allows collaborative assessment of the social context of reintegration with community members. International Registered Report Identifier (IRRID): DERR1-10.2196/14170

Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) can negatively affect quality of life and social functioning. This study examined the relationship between PTSD and social participation in a cohort of veterans and service members (V/SM). Participants included 242 adults enrolled in the Veterans Affairs Traumatic Brain Injury Model Systems (VA TBIMS) multicenter study. Social participation was measured with the Participation Assessment with Recombined Tools-Objective. PTSD symptoms were assessed with the PTSD Checklist-Civilian Version at admission, and TBI severity was determined with the Glasgow Coma Scale. Neither TBI severity nor PTSD were associated with lower social participation at 1-year post-TBI. Marital status was the only significant predictor of social participation within this sample of V/SM with primarily moderate to severe TBI. Married V/SM with TBI reported more social participation which could lead to better rehabilitation outcomes. Unmarried V/SM may need more assistance with engagement in social activities, which can be a rehabilitation treatment target.