A Network Analysis of the PART-O at 1 and 2 Years After TBI: A Veterans Affairs Model Systems Study

Samuel J. West, Daniel W. Klyce, Paul B. Perrin, Shannon B. Juengst, Kristen Dams-O’Connor, Tiffanie A. Vargas, Ria Grover, Jacob A. Finn, C. B. Eagye, Stephanie D. Agtarap, Joyce S. Chung, Thomas A. Campbell

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: The construct of participation after traumatic brain injury (TBI) can be difficult to operationalize. Psychometric network analysis offers an empirical approach to visualizing and quantifying the associations between activities that comprise participation, elucidating the relations among the construct’s components without assuming the presence of a latent common cause and generating a model to inform future measurement methods. The current research applied psychometric network analysis to the Participation Assessment with Recombined Tools-Objective (PART-O) within a sample of service members and veterans (SM/Vs) with a history of TBI at 1 and 2 years (T1 and T2) postinjury. Participants: Participants (N = 663) were SM/Vs with a history of TBI who completed comprehensive inpatient rehabilitation services at a Department of Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC). Setting: Five VA PRCs. Design: Cross-sectional, retrospective analysis of data from the VA TBI Model Systems study. Main Measures: PART-O. Results: Network analysis demonstrated that the PART-O structure was generally consistent over time, but some differences emerged. The greatest difference observed was the association between “spending time with friends” and “giving emotional support” to others. This association was more than twice as strong at T2 as at T1. The “out of the house” item was most central, as demonstrated by dense connections within its own subscale (Out and About) and items in other subscales (ie, Social Relations and Productivity). When examining items connecting the 3 subscales, the items related to giving emotional support, internet use, and getting out of the house emerged as the strongest connectors at T1, and the internet was the strongest connector at T2. Conclusion: Providing emotional support to others is associated with greater participation across multiple domains and is an important indicator of recovery. Being out and about, internet use, and engagement in productive activities such as school and work shared strong associations with Social Relations. Network analysis permits visual conceptualization of the dynamic constructs that comprise participation and has the potential to inform approaches to measurement and treatment.

Original languageEnglish (US)
Pages (from-to)401-409
Number of pages9
JournalJournal of Head Trauma Rehabilitation
Issue number5
StatePublished - Sep 1 2023

Bibliographical note

Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.


  • community reintegration
  • network analysis
  • participation
  • traumatic brain injury
  • veterans

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, N.I.H., Extramural


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