Each year, millions of children sustain concussions/mild traumatic brain injuries (mTBI), and 15-25% suffer persistent symptoms and declines in quality of life. Clinicians caring for these children face three critical, unanswered questions: how to diagnose concussion, how to predict which children will suffer persistent symptoms, and how to treat those who do? The overall goal of this program of research is to answer these questions through an interdisciplinary program that combines systematic research, embedded knowledge translation (KT), and training/mentoring. The long-term vision is to transform clinical care and improve outcomes for children with concussion.
The Advancing Concussion Assessment and Treatment in Children and Youth (A-CATChY) research plan has two core aims. Aim 1 will improve diagnosis and prognosis of mTBI by focusing on assessment. The objective is to conduct a prospective, longitudinal, multi-site cohort study that assesses novel neurobiological and psychosocial markers (e.g., genes; psychological hardiness) hypothesized to (1) identify mTBI and (2) predict outcomes of mTBI. The findings will enable better detection of mTBI in children, especially those at risk for poor outcomes, and help identify modifiable risk factors. These factors are targeted by Aim 2, which will improve the treatment of persistent symptoms. The objective is to design and test neurocognitive and psychosocial interventions hypothesized to reduce children’s post-concussive symptoms. The interventions will be tested in randomized controlled trials (RCTs), first individually and subsequently in multi-arm RCTs involving promising biomedical treatments (e.g., melatonin, cervico-vestibular therapy).
The research program responds directly to the concerns of patients, families, clinicians, institutional decision makers (e.g., Alberta Health Services), and other knowledge users. It builds on these partnerships via an integrated knowledge translation plan, which includes an advisory committee to provide ongoing stakeholder participation, patient engagement researchers to generate research by and for patients, and a dedicated knowledge broker to weave a broad translational network and build a strategy for the dissemination and uptake of study findings by scientists and end users.
The program will build research capacity via interdisciplinary training and mentoring along a “multi-generational” chain. Dr. Yeates’s students and trainees, as well as those supervised by other research team members, will be immersed in the research program and engage in program-specific training activities (e.g., mentoring committees, lab rotations, annual conference) while capitalizing on institutional educational opportunities. In addition, senior investigators on the team will mentor junior members and support them in developing independent research.
Funding: Canadian Institutes of Health Research (CIHR) Foundation Grant
Amount of grant awarded: $3,717,742
Program years: 2015-2023