{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T18:58:12Z","timestamp":1782932292208,"version":"3.54.5"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009157","name":"National Institute on Disability, Independent Living, and Rehabilitation Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009157","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>Traumatic brain injury (TBI) can lead to a host of challenges and negatively impacts Native Americans more than any other ethnic group in the U.S. Despite this, little research exists on Native Americans with TBI. The current study examined disparities in global outcome trajectories (overall level of function post-injury) between Native Americans and White individuals in the 5 years following TBI and whether sociodemographic or injury-related characteristics could account for this disparity.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Method<\/jats:title>\n<jats:p>The current study used a sample of 75 Native Americans demographically matched by sex, age, and injury severity to 75 White individuals from the U.S. Traumatic Brian Injury Model Systems (TBIMS) database (n =\u2009 150). A series of hierarchical linear models (HLMs) was used to examine longitudinal global outcome trajectories between the two groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Native Americans showed lower global outcome scores than their White counterparts with this difference worsening (i.e., growing larger) over time. The difference in scores and the differential movement over time were associated with differences between the ethnic groups in employment at the time of injury, substance use patterns, and type of insurance.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study highlights the need for identification of and early intervention for risk factors that predict disparities in rehabilitation outcomes and points to the need for greater access to culturally informed care for Native Americans with TBI.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0321279","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T17:57:08Z","timestamp":1744135028000},"page":"e0321279","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Disparities between native americans and white individuals in global outcome trajectories over the 5 years after traumatic brain injury: A model systems study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1348-4214","authenticated-orcid":true,"given":"Jack D.","family":"Watson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-215X","authenticated-orcid":true,"given":"Paul B.","family":"Perrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Arango-Lasprilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"pone.0321279.ref001","author":"Centers for Disease Control and Prevention","year":"2019"},{"issue":"9233","key":"pone.0321279.ref002","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/S0140-6736(00)02689-1","article-title":"Traumatic brain injury","volume":"356","author":"J Ghajar","year":"2000","journal-title":"The Lancet"},{"issue":"12","key":"pone.0321279.ref003","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research","volume":"16","author":"AIR Maas","year":"2017","journal-title":"Lancet Neurol"},{"key":"pone.0321279.ref004","author":"Centers for Disease Control and Prevention","year":"2018"},{"issue":"4","key":"pone.0321279.ref005","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1136\/jnnp.44.4.285","article-title":"Disability after severe head injury: observations on the use of the Glasgow Outcome Scale","volume":"44","author":"B Jennett","year":"1981","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"3","key":"pone.0321279.ref006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1097\/AIA.0b013e318078cfe7","article-title":"Traumatic brain injury","volume":"45","author":"S Parikh","year":"2007","journal-title":"Int Anesthesiol Clin"},{"issue":"10","key":"pone.0321279.ref007","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1089\/neu.1997.14.715","article-title":"Progressive atrophy and neuron death for one year following brain trauma in the rat","volume":"14","author":"DH Smith","year":"1997","journal-title":"J Neurotrauma"},{"issue":"4","key":"pone.0321279.ref008","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/HTR.0000000000000465","article-title":"Prevalence of medical and psychiatric comorbidities following traumatic brain injury","volume":"34","author":"FM Hammond","year":"2019","journal-title":"J Head Trauma Rehabil"},{"issue":"3","key":"pone.0321279.ref009","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.apmr.2017.06.012","article-title":"Health conditions: effect on function, health-related quality of life, and life satisfaction after traumatic spinal cord injury. 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