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Hundreds of thousands of U.S. veterans and their families are significantly affected by traumatic brain injury (TBI), yet policy-makers and the general public often lack knowledge about TBI and other “invisible injuries” related to military service. Veterans may face delayed TBI diagnoses and trouble accessing needed health care, and they and their families may face stigma and misperceptions about TBI that impede successful community reintegration. Researchers in the Department of Veterans Affairs (VA) partnered with 45 veterans with TBI and 26 of their family caregivers on a participatory action research (PAR) study that used photovoice methods to explore and convey experiences of community reintegration after TBI. Interview data and images taken by participants were used to communicate stories, reflections, and insights. This paper reports participants’ reflections about (a) how they became aware of TBI-related symptoms and the impact of TBI on their lives and relationships, (b) challenges they have encountered—including misconceptions and stigma—when disclosing TBI and other “invisible injuries” to others, and (c) strategies and resources they draw upon to counter these challenges. The authors conclude by sharing participant-identified recommendations for supporting community reintegration after military service–related TBI. This work demonstrates the power of PAR to engage veterans and family caregivers in generating knowledge to inform the programs, policies, and public discourse that affect their lives. A priority for the dissemination of the study’s findings has been to raise awareness about TBI among veterans and military caregivers.


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19 Jul 2022
71.9 kB
19 Jul 2022
152 kB
19 Jul 2022
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  • Alternative title
    • Participatory Action Research to Increase Awareness Around Military-Related Traumatic Brain Injury

  • Journal title
    • Journal of Community Engagement and Scholarship

  • Volume
    • 13

  • Issue
    • 4

  • Date submitted

    19 July 2022

  • License
  • Keywords
  • Additional information
    • Acknowledgements:

      We wish to acknowledge the veterans and family caregivers who collaborated on this work with us and shared their stories, experiences, and perspectives because of a desire to learn more about themselves and to be of service to others. We would also like to thank our families and loved ones for their support of us and of this work. We acknowledge the important contributions of other research team members over the years, especially Traci Abraham, PhD, for her involvement in coding transcripts from photo-elicitation interviews, Mary Frances Ritchie, MPH, and Ryan Bender, MSW, who collected data, coded, and maintained communication with participants. We thank the anonymous reviewers for their helpful comments. The study was supported by VA HSR&D award IIR 14-399. Gala True also receives support from the South Central Mental Illness Research, Education, and Clinical Center (SC MIRECC). At the time of this research Sarah Ono was supported by the Center to Improve Veteran Involvement in Care (CIVIC).