{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:12:46Z","timestamp":1792649566558,"version":"4.5.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Over 514,000 active duty Service Members (SMs) have sustained traumatic brain injuries (TBIs) since 2000, with mild TBI (mTBI) emerging as the signature injury of recent wars. Although many recover fully, some experience chronic mTBI with persistent symptoms such as headaches, memory issues, post-traumatic stress disorder (PTSD), chronic pain, depression, and cognitive impairment. The 2021 Department of Veterans Affairs (VA)\/Department of Defense (DOD) clinical practice guidelines (CPGs) recommend symptom-focused treatment, addressing comorbid conditions, and supporting reintegration. Congress mandated specialized centers to provide comprehensive care, research, and rehabilitation for combat-injured Veterans and SMs (V\/SMs) leading to the development of Intensive Evaluation and Treatment Programs (IETPs) at 5 VA Polytrauma Rehabilitation Centers offering interdisciplinary, individualized inpatient care. The IETPs integrate rehabilitation and specialty services for V\/SMs with chronic mTBI and associated health issues.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The study aimed to describe the IETPs and the participants it serves with chronic, multiple mTBI and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were V\/SMs enrolled in the VA TBI Model Systems study and admitted to 1 of the 5 IETPs between 2009 and 2023. Inclusion criteria included TBI diagnosis, age \u226516, and consent for study participation. Data included demographics, military service characteristics, TBI history, and comorbidities. Injury data represented the index TBI qualifying participants for the study, although many had multiple TBIs. Measures included Functional Independence Measure, Disability Rating Scale, PTSD Checklist, and Neurobehavioral Symptom Inventory, among others.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There have been 821 IETP participants from the program start through 2023. Participants averaged 35.3\u2009years at admission, were predominantly White, non-Hispanic, married men, and included active duty SMs, many from Special Operations Forces (74.2%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Conclusions<\/jats:title>\n                  <jats:p>Our findings show the prevalence of participants with comorbidities at IETP admission. The 2021 VA\/DOD CPGs caution against over-involvement of specialty care for mTBI but acknowledge that patients with persistent symptoms and comorbidities may benefit from specialized programs like IETPs. Chronic pain, sleep apnea, musculoskeletal issues, and hypertension were common among IETP participants, highlighting the need for intensive inpatient care to address dynamic and interactive symptoms. IETPs provide integrated treatment, removing external demands and offering opportunities for medication trials, interventions, and evidence-based therapies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf159","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T22:21:19Z","timestamp":1758320479000},"page":"281-287","source":"Crossref","is-referenced-by-count":4,"title":["Characterization of Service Members and Veterans with Mild Traumatic Brain Injury Participating in the Department of Veterans Affairs Intensive Evaluation and Treatment Programs"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5251-7501","authenticated-orcid":false,"given":"Jessica L","family":"Ryan","sequence":"first","affiliation":[{"name":"Research and Development Service, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612, United States"},{"name":"Department of Emergency Medicine, Morsani College of Medicine, University of South Florida , Tampa, FL 33602,","place":["United States"]},{"name":"Tampa VA Research and Education Foundation, Inc. , Tampa, FL 33617,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari H","family":"Venkatachalam","sequence":"additional","affiliation":[{"name":"Research and Development Service, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W","family":"Klyce","sequence":"additional","affiliation":[{"name":"Mental Health Service, Central Virginia VA Health Care System , Richmond, VA 23249,","place":["United States"]},{"name":"Psychology Service, Sheltering Arms Institute , Richmond, VA 23233,","place":["United States"]},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University , Richmond, VA 23298,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A","family":"Finn","sequence":"additional","affiliation":[{"name":"Department of Psychiatry & Behavioral Sciences, University of Minnesota-Twin Cities , Minneapolis, MN 55454,","place":["United States"]},{"name":"Physical Medicine & Rehabilitation, Minneapolis VA Health Care System , Minneapolis, MN 55417,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2935-8386","authenticated-orcid":false,"given":"Natalie M","family":"Gilmore","sequence":"additional","affiliation":[{"name":"Research and Development Service, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612, United States"},{"name":"Tampa VA Research and Education Foundation, Inc. , Tampa, FL 33617,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Morsani College of Medicine, University of South Florida , Tampa, FL 33606,","place":["United States"]},{"name":"Mental Health & Behavioral Science Service, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J","family":"Munger","sequence":"additional","affiliation":[{"name":"Polytrauma Rehabilitation Center, VA Palo Alto Health Care System, Polytrauma System of Care , Palo Alto, CA 94304, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M","family":"Picon","sequence":"additional","affiliation":[{"name":"Office of Rehabilitation and Prosthetic Services, Patient Care Services, Veterans Health Administration , Washington, DC 20420,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risa","family":"Nakase-Richardson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Morsani College of Medicine, University of South Florida , Tampa, FL 33606,","place":["United States"]},{"name":"Chief of Staff Office, James A. Haley Veterans\u2019 Hospital , Tampa, FL 33612,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia A","family":"Swan","sequence":"additional","affiliation":[{"name":"Department of Psychology, The University of Texas at San Antonio, One UTSA Circle , San Antonio, TX 78249,","place":["United States"]},{"name":"Physical Medicine & Rehabilitation Service, Audie L. Murphy Memorial Hospital , San Antonio, TX 78229,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Morsani College of Medicine, University of South Florida , Tampa, FL 33606,","place":["United States"]},{"name":"Mental Health & Behavioral Science Service, James A. 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