Snell, DLFaulkner, JWWilliman, JASilverberg, NDTheadom, ASurgenor, LJHackney, JSiegert, RJ2023-06-052023-06-052023-02-22Brain Injury, ISSN: 0269-9052 (Print); 1362-301X (Online), Informa UK Limited, 37(6), 1-10. doi: 10.1080/02699052.2023.21806630269-90521362-301Xhttps://hdl.handle.net/10292/16224Objectives: Fear avoidance is associated with symptom persistence after mild traumatic brain injury (mTBI). In this study, we investigated whether fear avoidance was associated with other outcomes such as return to work-related activity (RTW). Materials and Methods: We analyzed associations between fear avoidance and RTW 6–9 months after mTBI, in two merged prospective mTBI cohorts. Adult participants aged 16 or over (n=175), presenting to outpatient services in New Zealand within 3 months of their injury, who were engaged in work-related activity at the time of injury, were included. Participants completed the Fear Avoidance Behavior after Traumatic Brain Injury (FAB-TBI) questionnaire at enrollment and 6 months later. Associations between FAB-TBI scores and RTW outcome were analyzed using multivariate approaches. Results: Overall, 53% of participants had RTW by 6–9 months after mTBI. While early fear avoidance was weakly associated with RTW, persistent high fear avoidance between study assessments or increasing avoidance with time were associated with greater odds of still being off work 6–9 months after injury. Conclusions: Pervasive and increasing avoidance of symptom triggers after mTBI were associated with lower rates of RTW 6–9 months after mTBI. Further research is needed to better understand transition points along the recovery trajectory where fear avoidance behaviors fade or increase after mTBI.http://creativecommons.org/licenses/by-nc-nd/4.0/Mild TBIRTWfear avoidancereturn to work4201 Allied Health and Rehabilitation Science42 Health SciencesNeurosciencesBehavioral and Social ScienceTraumatic Brain Injury (TBI)Physical Injury - Accidents and Adverse EffectsBrain DisordersTraumatic Head and Spine InjuryClinical Research11 Medical and Health Sciences17 Psychology and Cognitive SciencesRehabilitation3202 Clinical sciences4201 Allied health and rehabilitation science5203 Clinical and health psychologyHumansBrain ConcussionProspective StudiesFearAdultReturn to WorkBrain Injuries, TraumaticJournal ArticleOpenAccess10.1080/02699052.2023.2180663