New Research Project Looks at Feasibility of a Hybrid Model for SHARE Military Initiative

Can a hybrid model of care — one that combines in-person treatment and virtual services — effectively treat clients in Shepherd Center’s SHARE Military Initiative? That’s what a new research project funded by Wounded Warrior Project® (WWP) aims to find out.

When the COVID-19 pandemic hit, SHARE, a comprehensive program that treats post-9/11 service members and veterans with traumatic brain injuries (TBI) and any co-occurring psychological or behavioral health concerns, was one of several outpatient programs to shut down to reduce the risk of spreading the virus.

Staff members sprung to action to continue to meet the needs of their SHARE clients, and within four weeks, SHARE began operating as a remote telemedicine program, with therapy sessions offered to SHARE clients virtually. Once COVID-19 testing was in place, a small group returned to the hospital, enabling the SHARE staff to switch to a hybrid model where clients spent a week at Shepherd Center and then returned to their homes to complete virtual treatment.

“We were forced to innovate using existing technology to offer speech, occupational and other therapies over a telemedicine platform,” says Russell Gore, M.D., medical director of SHARE. “As a treatment program we learned a lot from that effort. Now, we want to test the effectiveness of the hybrid treatment model.”

WWP’s funding will cover the cost of growing and assessing hybrid treatment, including a new neuropsychology research fellow, who will develop research protocols, collect and analyze data, and conduct literature reviews.

“We believe that no one organization can solve the significant challenges that wounded veterans face,” says WWP CEO Lt. Gen. (Ret.) Mike Linnington. “The investments we make into brain health research and partner organizations like Shepherd Center’s SHARE Military Initiative are critical to building strong, resilient veteran families and communities.”

“We are grateful for their support,” adds Jon Roxland, senior director of philanthropy and partnerships at Shepherd Center. “Any time we can partner with a leading organization like Wounded Warrior Project, it increases the credibility and visibility of our program.”

This two-year research study will look at two groups of 30 clients each (one group per year) and compare their outcomes with those who only did in-person therapy. Along with Dr. Gore, Brick Johnstone, Ph.D., ABPP, Shepherd Center’s O. Wayne Rollins Director of Brain Injury Research, will oversee the study. Jessica Pan Conklin, Ph.D., recently accepted the position of research fellow.

“This is an opportunity to gauge how hybrid care can affect patient outcomes,” Dr. Gore says. “We hope it will be equivalent at the very least. If we can establish that certain variables predict a better outcome with in-person versus hybrid care, we can make recommendations supported by our data.”

The researchers also hope to demonstrate how the hybrid model can improve access to care. While SHARE has the flexibility to create programs of varying lengths to meet individual clients’ needs, because of work and family commitments, it may not be feasible for clients to travel to Shepherd Center for treatment. With the hybrid model, SHARE can accommodate a greater number of clients, often regardless of their geographic location.

Because of the nature of SHARE clients’ injuries, they benefit greatly from being around each other, which is why the program is using a hybrid model combining telemedicine and in-person care.

“SHARE clients have complex histories and complex injuries,” Dr. Johnstone says. “They need to be here with other veterans, but if we can demonstrate they also benefit from telemedicine, it provides us with more options.”

The research also has implications for other similar programs across the country.

“SHARE has a reputation for effective, innovative clinical treatments for putting veterans’ needs first,” Dr. Johnstone says. “We can do more because we have a larger program. If we show the effectiveness of a hybrid model, it could be used in other places.”

To learn more about the SHARE Military Initiative, visit shepherd.org/share.

Written by Sara Baxter