Perspectives on traumatic brain injury screening among intersecting underserved populations: an exploratory study

PURPOSE: This study aimed to explore barriers and facilitators in traumatic brain injury (TBI) screening for underserved individuals and knowledge translation efforts to address challenges. MATERIALS AND METHODS: Guided by qualitative description, we conducted four virtual focus groups: 10 people (7 female, 3 male) with lived experience of precarious housing, criminal legal involvement, and/or violence and 11 service providers (9 female, 2 male) supporting these populations with TBI. Data were analyzed using thematic analysis. FINDINGS: Barriers to TBI screening included (1) inconsistent implementation and competing priorities within organizations; (2) stigmatization and systemic challenges in service provision; and (3) a lack of a universal screening system and follow-up pathways. While potential facilitators to screening involved language, knowledge and resources, as identified in the following themes: (1) language matters: shaping conversations in TBI screening; (2) screening for all: knowledge and access; and (3) easy and engaging tools for screening. CONCLUSIONS: Barriers to TBI screening persist. Systemic changes and targeted educational initiatives are needed to improve knowledge and awareness of TBI with sensitivity to potential circumstances of specific populations. Affirming conversational language in screening, along with providing tailored resources and access to follow-up support services that address social determinants of health, are essential.