Culture Shift Within the Department of Defense Regarding Brain Injury Detection and Treatment

Abstract

Objectives

To identify facilitators and barriers to implementing policy within the Department of Defense (DOD).

Design

Five DOD stakeholders participated in individual qualitative interviews and were recruited through presentations, emails, and snowball sampling. The interviews were conducted by 2 trained interviewers using a semistructured interview script. The interviews were audio-recorded and transcribed for analysis. Analysis was conducted using grounded theory then organized into themes.

Setting

Research activities were conducted in-person at the James A. Haley VA in Tampa, Florida, and virtually through Microsoft Teams.

Participants

Participants were administrative stakeholders from the Department of Defense.

Interventions

No intervention was used.

Main Outcome Measures

Demographic survey and semistructured qualitative interviews.

Results

Based on interview findings, the DOD has developed organizational goals related to changing the culture of the military regarding service member brain injury (reducing stigma associated with reporting injury and seeking care), ensuring consistent services across regions, and providing appropriate education and training across the operational and medical specialties within the military. Facilitators to supporting change included implementing policies, leadership buy-in, leveraging partnerships with operational and research communities, stakeholders, and families, changing language to reduce stigma, education, and training. However, implementing change is not without barriers. Participants listed several barriers to implementing change including inability to monitor implementation of policies, leadership changes, lack of buy-in, translating research into practice, overlap and confusion regarding new policies and existing policies, lack of standardized care, and staffing shortages.

Conclusions

Policy implementation within the DOD has supported a cultural shift in how service member brain injury is recognized and treated. The findings suggest a continued need for strategies to ensure effective policy implementation.

Disclosures

The authors have no disclosures to report. The views expressed in this abstract are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. For more information, please contact [email protected].