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Utilization Based Technology Assessment and Evaluation of Cognitive Assessments for Canadian Armed Forces Members with Mild Traumatic Brain Injury

  • Author / Creator
    Jones, Chelsea
  • Canadian Armed Forces service members (CAF-SMs) have an increased risk of sustaining mild traumatic brain injuries (mTBI; Garber, Rusu, & Zamorski, 2014). MTBI can result in reduced cognitive functioning which may lead to barriers to participation in everyday occupations of CAF-SMs. Military contexts necessitate high levels of cognitive functioning; compromising this can potentially result in decreased efficiency and effectiveness, along with an increased risk of harm to self, the unit, and mission (Radomski, Davidson, Voydetich, & Erickson, 2009). Assessing cognitive functioning is necessary to ensure that CAF-SMs can perform their military duties safely and proficiently. Interventions to improve cognitive functioning are most effective when a reliable, valid, specific, and function-based cognitive assessments are employed (Radomski, Davidson, Voydetich, & Erickson, 2009; Soble, Critchfield, & O’Rourke, 2016). Despite this, healthcare professionals commonly assess cognition utilizing dated assessments with varying levels of validity and reliability, and only measure specific domains of cognition (Larner, 2017). Neurocognitive computerized assessment tools (NCATs) are widely utilized in other global militaries and have multiple benefits including potentially increased inter- and intra-rater reliability, ease of administration, reduced time to administer, and ease of calculating and analysing results (Cernich, Brennana, Barker, & Bleiberg, 2007). Evidence-based research of cognitive assessments with the CAF context is required to increase the safety, productivity, and quality of life of those CAF-SMs affected by mTBI. Even when cognitive assessment tools that embrace technology are utilized, significant gaps in research and clinical knowledge remain. The overall purpose of this research is to investigate best practice approaches for the implementation of cognitive assessments for CAF-SMs who have sustained an mTBI. This will assist with advancing clinical practices within CFHS and improve healthcare services for this demographic. A pragmatic paradigm is the essence of this project and a mixed-methods research design will be employed throughout. By meeting the CAF organization at their point of current progress and aligning realistically with their current state of policy, procedure, and plans, a feasible implementation path will emerge leading to better healthcare for those CAF-SMs who experience cognitive dysfunction due to mTBI. The overall project will be guided by the Active Implementation Frameworks (AIFs; Fixsen, Naoom, Blase, Friedman, & Wallace, 2005) and Utilization-Focused Evaluation Framework (UFE; Patton, 2013). This PhD project consists of 4 sections which follow the stages of AIFs and UFE and mixed-method research design: 1. A Model for Neurofunctional Health: The Canadian Model of Cognitive Skills 2. Neurocognitive Assessment Tools for Military Personnel with Mild Traumatic Brain Injury: A Scoping Literature Review 3. Perceptions of Canadian Armed Forces Healthcare Professionals on Cognitive Assessment Processes within Canadian Armed Forces Health Services: A Mixed Methods Analysis 4. Technology Acceptance of the BrainFX® SCREEN amongst Canadian Armed Forces Members and Veterans with Combat Related Posttraumatic Stress Disorder: Pre/Post Analysis

  • Subjects / Keywords
  • Graduation date
    Spring 2021
  • Type of Item
    Thesis
  • Degree
    Doctor of Philosophy
  • DOI
    https://doi.org/10.7939/r3-sn58-6f66
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.