Understanding Home Safety Concerns for Adolescents With Brain Injuries: An Evaluation of Hazards, Risks, & Harms

PURPOSE: Acquired brain injury (ABI) is a leading cause of death and disability among children and adolescents. These youth experience many functional impairments impacting their daily life, but little is known about safety hazards and injury risk. This research aimed to identify home safety hazards that pose risks to adolescents with ABI. DESIGN: This study was part one of a descriptive study using a convergent mixed-methods instrumental case study design, intended to collect pilot data about home safety hazards for this population. Participants were eligible if they were a healthcare provider (e.g., OT, SLP, PT), an adolescent (aged 12-19) diagnosed with ABI, or a primary caregiver of an adolescent with ABI. Participants were recruited via word of mouth/fliers and medical record data from the community and the local children's hospital. METHOD: Participants completed questionnaires and activities on demographics (and injury severity) and home safety hazards. Participants also completed individual or group interviews to examine their clinical/rehabilitation experiences and home safety hazards and concerns. Questionnaire data were analyzed with descriptive statistics, and interview transcripts were coded and thematically analyzed. RESULTS: Participants included 13 healthcare providers, 5 adolescents with ABI, and 5 caregivers. While all providers agreed that all pre-identified hazards were safety concerns for this population, less than 40% of those hazards were concerns for adolescents or caregivers. Also, 60% of adolescents self-identified no hazards. Several themes were created, and these data led to the development of a conceptual model detailing the relationship between hazards, risks, and harms for this population. CONCLUSION: These findings identify the home safety hazards posing risks to adolescents with ABI. This research will improve our understanding of home safety for adolescents with ABI and be used to develop targeted injury prevention tools.