Mild traumatic brain injury (mTBI) is a prevalent and costly public health problem with disabling consequences. Approximately 1.3 million individuals with mTBI are treated in US hospitals and Emergency Departments (ED) each year. Many individuals experience physical, cognitive, psychiatric and functional symptoms immediately following mTBI. Substance abuse often co-occurs with mTBI, and alcohol related disorders are linked to risk for initial and subsequent injuries. While most recover quickly, a subgroup of between 10-15% of individuals experience disabling and prolonged symptoms. Considering the high incidence of mTBI each year, the subgroup of patients reporting prolonged and severe symptoms represent a significant number of people with high medical costs and high levels of lost productivity and distress. Unfortunately, the state of current knowledge leaves these patients difficult to identify acutely, and psychosocial assessments and acute interventions for these patients are underdeveloped. As a result, many patients with significant symptoms are lost to follow up and do not receive needed services. Economically and socially disadvantaged populations, whom consistently experience significant barriers to accessing appropriate medical and psychiatric care, are disproportionately affected by these consequences. Social workers are embedded in medical treatment teams; they are efficient and effective providers of psychosocial interventions. However, they have had extremely limited engagement in mTBI intervention studies to date. The SWIFT study aims to test a brief, social work delivered, multi-component assessment and intervention to address post-mTBI symptoms and to detect and link those experiencing significant symptoms to targeted outpatient services. SWIFT includes, 1) brief intervention in the ED (SWIFT-Acute) and 2) follow up telephone assessment, intervention and targeted referral based on assessment (SWIFT-Follow Up).
The specific aims of the study are: 1) Conduct randomized clinical trial to assess feasibility of SWIFT and preliminary, comparative effectiveness of SWIFT-Acute (N=40) and SWIFT-Follow Up (N=40) on prevention or reduction of alcohol use, community and social functioning, post-concussive symptoms, depression, anxiety, and successful linkage to outpatient resources, 2) Utilize qualitative interviews to assess acceptability and satisfaction with SWIFT from patient (N=40) and provider/stakeholder perspectives (N=10), and 3) Modify and complete development of SWIFT intervention based on results from aims 1 and 2.

Institute of Translational Health Sciences, Multidisciplinary Clinical Research Career Development Program, National Center for Research Resources, NIH/NCATS 2 KL2 TR000421-06
Other Investigators: 
Other Names: 
Jesse Fann, Geoffrey Manley, Martha Shumway