OBJECTIVE: To characterize the intervention elements associated with improvements in activity and participation outcomes for adults with brain injury. DATA SOURCES: PubMed and PsycINFO/Ovid. STUDY SELECTION: We included RCTs that examined interventions for adults with acquired brain injury with an activity or participation outcome measure. DATA EXTRACTION: We classified intervention elements and extracted effect sizes. We examined patterns of effect sizes associated with each intervention element based on time of follow-up and level of outcome (home versus community). DATA SYNTHESIS: Thirty-nine articles were included. Outcomes focused on the performance of home and community activities. There was wide variation in effect sizes across all intervention elements, as well as by time and by outcome level (home versus community). Metacognitive interventions and daily life skills interventions showed the greatest promise for improving performance of home and community activities. Additionally, cognitive training interventions may play a role in improving home activity performance and social skills training interventions may play a role in community activity performance. Physical activity interventions showed the least promise for improving home and community activity performance. CONCLUSION: This study highlights the importance of interventions that incorporate explicit strategies and task-specific training, rather than only addressing specific injury-related impairments.

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