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A Web-Based Videoconferencing Approach to Training Caregivers in Rural Areas to Compensate for Problems Related to Traumatic Brain Injury

Sander, Angelle M. PhD; Clark, Allison N. PhD; Atchison, Timothy B. PhD; Rueda, Misty BA

Section Editor(s): Bell, Kathleen R. MD; Hart, Tessa PhD

Journal of Head Trauma Rehabilitation: July-August 2009 - Volume 24 - Issue 4 - p 248–261
doi: 10.1097/HTR.0b013e3181ad593a

Objective To describe the development and the implementation of a Web-based, videoconferencing training program for caregivers of adults with traumatic brain injury in rural areas to manage cognitive and behavioral changes in the person with the injury.

Design Feasibility study, with satisfaction and perceived utility assessed.

Intervention Six Web-based videoconference sessions, combining didactic education and interactive problem-solving.

Participants Fifteen caregivers of persons with complicated mild, moderate, or severe traumatic brain injury, who were admitted to a level III trauma center in a rural area of Texas.

Measures Satisfaction survey and perceived utility questions conducted immediately following training and at an average of 18 months after training.

Results Participants' overall satisfaction and comfort with the training was high. They perceived that they gained knowledge that was applicable to the everyday problems being experienced. At follow-up, all participants reported having used the knowledge gained to help cope with problems and all had referred to the written materials at least once since the training.

Conclusions Web-based videoconferencing can be used to provide training to caregivers to manage cognitive and behavioral problems resulting from traumatic brain injury. However, there are obstacles related to willingness to seek help among persons in rural areas that must be overcome.

Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas; Harris County Hospital District, Houston, Texas; and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Drs Sander and Clark); and Department of Psychology, Sociology, and Social Work, West Texas A&M University, Canyon, Texas (Dr Atchison and Ms Rueda).

Corresponding Author: Angelle M. Sander, PhD, Memorial Hermann, TIRR, Brain Injury Research Center 2323 South Shepherd Ste 907, Houston, TX 77019 (

This work was supported by a grant from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education (grant no. H133B031117, Rehabilitation Research and Training Center on Community Integration in Persons With Traumatic Brain Injury). The authors thank staff at the West Texas A&M Interactive T.V. Center; Deann Hoececk, MA, Laura Rosas, MA, and Delisa West, PhD, for contributing to the development of the sessions; and Jason and Susannah Ferguson for consumer review of the sessions.

© 2009 Lippincott Williams & Wilkins, Inc.