When a brain is injured by sudden violence or accident, the wound ripples outward — landing not only on the patient but on the family members who must hold everything together in the aftermath. A University of Cincinnati physician-researcher, drawing on years of witnessing this silent suffering in the neuro ICU, has secured $2.5 million from the National Institutes of Health to test whether a structured digital and telephone wellness program can meaningfully reduce the anxiety, depression, and burnout that consume so many caregivers during the first six months of a loved one's traumatic brain
NIH Awards $2.5M Grant for TBI Caregiver Wellness Intervention Trial
Family caregivers of traumatic brain injury patients experience significant psychological distress including anxiety, depression, and burnout during recovery.
The first six months after injury are especially demanding for caregivers
Mark
Why does this matter now? Are family caregivers of TBI patients in crisis?
Mimi
They're under sustained, documented stress. The research shows high rates of anxiety, depression, and burnout, especially in those first six months when everything is happening at once—medical decisions, behavioral changes in the patient, and the caregiver's own mental health deteriorating.
Luke
But we should be clear: this is a trial to test whether an intervention works. We don't yet know if CG-Well 2 will actually reduce that distress at scale.
Mark
What makes this different from just giving people a pamphlet or a support group?
Mimi
It's structured and personalized. Forty-three modules tailored to what families actually face—FMLA paperwork, moving from ICU to rehab, preparing the home. And it's paired with real phone coaching from trained social workers or nurses, not just self-directed content.
Luke
The earlier trial, CG-Well 1, showed positive results, but it was smaller—100 caregivers. This new trial is testing whether it works across four different hospital systems with 354 pairs. That's a real test of scalability.
Mark
When does it start?
Mimi
Enrollment begins in early 2027. So we're still a few months away from seeing who actually enrolls and whether the program reaches the families who need it most.
Luke
And we won't have results for years. This is a five-year grant, so the trial itself will take time, and then there's analysis and publication.
Mark
So what's the real question being asked here?
Mimi
Can we reduce caregiver distress in a way that's practical, affordable, and works across different hospitals? If it does, it could change how we support families after traumatic brain injury.
Luke
And if it doesn't, we'll know that this particular approach—web modules plus phone coaching—isn't the answer, and we'll need to look elsewhere.
O Pulso
- Family caregivers of TBI patients face a largely invisible crisis — managing medical decisions, behavioral changes, and their own mental health simultaneously during one of the most disorienting periods a family can endure.
- Research has already confirmed what ICU nurses and physicians observe daily: anxiety, depression, and burnout are alarmingly common among this population in the critical first six months after injury.
- A pilot trial of CG-Well 1 with 100 caregivers showed real promise — those who received the structured intervention reported less psychological distress and greater satisfaction than those left without guidance.
- CG-Well 2 now scales that approach into 43 tailored modules delivered online and by phone, covering everything from stress management to FMLA navigation to the logistical maze of moving a patient from ICU to home.
- A multisite randomized trial enrolling up to 354 patient-caregiver pairs across four major U.S. universities is set to launch in early 2027, with cost-effectiveness and scalability as central measures of success.
When a brain is injured by sudden violence or accident, the wound ripples outward — landing not only on the patient but on the family members who must hold everything together in the aftermath. A University of Cincinnati physician-researcher, drawing on years of witnessing this silent suffering in the neuro ICU, has secured $2.5 million from the National Institutes of Health to test whether a structured digital and telephone wellness program can meaningfully reduce the anxiety, depression, and burnout that consume so many caregivers during the first six months of a loved one's traumatic brain injury recovery. The question at the heart of this work is not merely clinical — it is a question about how a society cares for those who care.
Natalie Kreitzer, an associate professor of clinical medicine at the University of Cincinnati, has received a five-year, $2.5 million NIH grant to test a structured wellness program for family caregivers of people with severe traumatic brain injuries. The funding comes from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and supports a multisite clinical trial of CG-Well 2 — a program Kreitzer built from her own experience working in the neuro ICU, where she watched family members absorb enormous strain alongside their injured loved ones.
Traumatic brain injury — caused by blows, jolts, or penetrating wounds from car crashes, falls, assaults, or gunshots — places extraordinary demands on caregivers during the first six months of recovery. They must navigate medical decisions, rehabilitation logistics, and behavioral changes in their loved one, often at the cost of their own mental health. Studies confirm that anxiety, depression, and burnout are widespread among this group during that critical window.
CG-Well 2 responds to this need with 43 tailored modules available online and in print, paired with regular phone coaching from trained social workers or nurses. Topics span stress management, Family and Medical Leave Act navigation, and the transition from intensive care to home. An earlier pilot trial, CG-Well 1, enrolled 100 caregivers and demonstrated that those receiving the intervention reported meaningfully less psychological distress than those in a control group.
The new trial will randomly assign up to 354 patient-caregiver pairs at four universities — Cincinnati, Ohio State, Washington University in St. Louis, and the University of Washington in Seattle — to either the full program or a control condition offering only publicly available resources and active-listening calls. Researchers will track caregiver wellbeing, patient outcomes, program acceptability, and cost. Enrollment is expected to begin in early 2027.
Natalie Kreitzer, an associate professor of clinical medicine at the University of Cincinnati, has secured a five-year, $2.5 million grant from the National Institutes of Health to test whether a structured online and telephone wellness program can ease the psychological toll on family members caring for people with severe traumatic brain injuries.
The grant, awarded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, funds a multisite clinical trial of CG-Well 2, a caregiver support intervention Kreitzer developed based on earlier research. The program delivers 43 tailored modules—available both online and in print—paired with phone coaching from trained social workers or nurses. Topics range from stress management and navigating the Family and Medical Leave Act to the practical logistics of transitioning a patient from intensive care to rehabilitation or home. Kreitzer, who completed a neurocritical care fellowship and works with the UC Stroke Team, said her interest in this work grew directly from her experience in the neuro ICU, where she witnessed the strain that family caregivers endure alongside their injured relatives.
Traumatic brain injury—a disruption in normal brain function caused by a forceful blow, bump, jolt, or penetrating object to the head—can result from motor vehicle collisions, assaults, gunshot wounds, or falls, particularly among older adults. The first six months after such an injury are especially demanding for caregivers, who must manage not only the immediate medical decisions and rehabilitation logistics but also cope with behavioral changes in their loved one while maintaining their own mental health. Research shows that family caregivers of TBI patients experience elevated rates of anxiety, depression, and burnout during this critical window.
Kreitzer's earlier work, the CG-Well 1 trial, enrolled 100 family caregivers with funding from an NIH career development award. That study showed promise: caregivers who received the intervention reported greater satisfaction and fewer symptoms of psychological stress compared to those in a control group. The new trial, CG-Well 2, will test whether the program can be scaled up and sustained across multiple hospital systems while remaining feasible and cost-effective.
The trial will randomly assign up to 354 patient-caregiver pairs at four universities—University of Cincinnati, Ohio State University in Columbus, Washington University in St. Louis, and the University of Washington in Seattle—to either the full intervention or a control condition. The intervention group will receive regular phone calls from a trained coach who guides them through the tailored modules. The control group will have access only to publicly available information and phone calls focused on active listening, without structured guidance or advice. Researchers will measure not only caregiver psychological distress and coping but also patient outcomes, the program's acceptability, and its cost. Enrollment is expected to begin in early 2027, with the trial running through the critical first six months after injury and the transition from hospital to home.
Citações Notáveis
From my experience in the neuro intensive care unit, I've developed a deep interest in working with patients who have suffered traumatic brain injuries and with their family members, who often become their caregivers.— Natalie Kreitzer, MD, associate professor of clinical medicine, University of Cincinnati
It was a positive trial. Caregivers enrolled in CG-Well reported greater satisfaction and fewer symptoms of psychological stress than those who received the control intervention.— Natalie Kreitzer, describing results from CG-Well 1
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