Challenges in delivering vital services during the COVID-19 pandemic: Perspectives from brain injury associations.

Research Objectives: To describe community brain injury (BI) associations’ experiences during the COVID-19 pandemic.

Design: Anonymous online survey study.

Setting: In January 2022 the project team, including community BI association co-investigators, collected responses from key stakeholders in the 70 eligible BI associations across Canada.

Participants: Respondents were from 45 associations, including associations in Pacific/Western (n=18; 40%), Central (n=25; 56%), and Atlantic Canada (n=2; 4%). Respondents were primarily paid executive directors (n=35; 78%) representing primarily associations employing 10 or less people (n=33; 77%) but serving 100 or more different clients (n=31; 69%) before the COVID-19 pandemic.

Interventions: None.

Main Outcome Measures: The online 26-item survey had quantitative and narrative questions about three main topics: association sustainability, meeting the needs of clients, and addressing public health.

Results: Thirty-four (76%) associations reported reductions in funding or financial resources during the pandemic which affected provision of programs or services, and only 14 (31%) received sufficient funds to a large or very large extent to cover additional pandemic-related expenses. Yet, twenty-eight (62%) associations reported increased demand for their programs or services, and 42 (93%) innovated their programs or services to meet varied and widespread client needs during the pandemic. Forty-two (93%) associations provided services or information to clients to explain public health guidelines, and forty-one (91%) associations reported clients experienced challenges in understanding and following public health guidelines. Narrative data provided further depth to the quantitative data.

Conclusions: Community BI associations have a vital role in the long-term rehabilitation and management of BI. However, the COVID-19 pandemic challenged BI associations to remain sustainable and meet the needs of their clients. Researchers and policy makers need to acknowledge and adequately support the indispensable work of associations in the BI rehabilitation continuum, as the loss of community BI associations could have vast ramifications.

Author(s) Disclosures: This survey study was funded in part by Canadian Institutes of Health Research (CIHR); the funder did not have a role in design, data collection, analysis, or reporting.