Effects of Web-Based Parent Training on Caregiver Functioning Following Pediatric Traumatic Brain Injury: A Randomized Control Trial

Raj, Stacey P.; Shultz, Emily L.; Zang, Huaiyu; Zhang, Nanhua; Kirkwood, Michael W.; Taylor, H. Gerry; Stancin, Terry; Yeates, Keith Owen; Wade, Shari L.

doi:10.1097/htr.0000000000000388

Cited by 12 publications

(32 citation statements)

References 32 publications

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“…Across all three reviews, the authors highlighted the general paucity of research on intervention studies for this population, despite great need. Studies tend to focus on families affected by pediatric traumatic brain injury in particular, though outcomes are mixed [ 91 , 92 , 93 , 94 , 95 ]. Of note, TIC is distinguished from these types of trauma-specific interventions designed to directly ameliorate the effects of past trauma [ 96 ].…”

Section: Resultsmentioning

confidence: 99%

Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

et al. 2022

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Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included.

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Section: Resultsmentioning

confidence: 99%

Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

et al. 2022

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“…We attempted to reduce heterogeneity of ABI by limiting our search strategy to traumatic brain injury and stroke etiologies (see Supplementary Material Table 1) since these are globally among the most frequent types of ABI that are associated with the highest rates of death and unfavorable outcomes in children [ 1 ]. Two intervention groups (I-InTERACT and I-InTERACT-Express) in one RCT [ 21 ] were combined for statistical analyses since both interventions used the same two-stage framework with web content and videoconferencing for live coaching, and they only differed by the omission of supplemental sessions in I-InTERACT-Express. Outcomes data from primary analyses (reported as intention-to-treat in three RCTs [ 21 – 23 ]) were extracted in all RCTs.…”

Section: Methodsmentioning

confidence: 99%

“…Two intervention groups (I-InTERACT and I-InTERACT-Express) in one RCT [ 21 ] were combined for statistical analyses since both interventions used the same two-stage framework with web content and videoconferencing for live coaching, and they only differed by the omission of supplemental sessions in I-InTERACT-Express. Outcomes data from primary analyses (reported as intention-to-treat in three RCTs [ 21 – 23 ]) were extracted in all RCTs. Discrepancies between the reviewers were rechecked and discussed until consensus was reached.…”

Section: Methodsmentioning

confidence: 99%

“…Meta-analyses were conducted if at least two RCTs had sufficient clinical and statistical homogeneity for at least one outcome of interest. Outcomes data was extracted from the immediate post-intervention period for two RCTs [ 22 , 23 ], at 6 months follow-up for one RCT [ 21 ], and at 18–36 weeks follow-up in one RCT [ 25 ]. A summary of the outcome measures of interest in each study, and the characteristics of each instrument are shown in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

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Effectiveness of Training Programs for Reducing Adverse Psychological Outcomes in Parents of Children with Acquired Brain Injury: A Systematic Review and Meta-Analysis

LaRovere

Tang

et al. 2022

Neurol Ther

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Introduction Parental stress following critical illness in their child has the potential to impact functional outcomes and quality of life for the child and whole family. Parent emotional functioning may also be an important clinical target to optimize child outcomes. This study assessed the effectiveness of training programs for parents aimed at reducing adverse psychological outcomes in parents of children with acute brain injury (ABI). Methods We conducted searches of Embase, PubMed, Web of Science, and Cochrane Library to November 13, 2020. Randomized controlled trials (RCTs) that compared parent training programs with usual care, or an active comparator, and assessed psychological outcomes (depression, anxiety, stress) in parents of children with ABI were included. Two reviewers independently extracted data on study characteristics, participants, interventions, outcome measures, and results before and after intervention. Risk of bias was assessed using the Cochrane risk-of-bias tool. Results Four RCTs involving 318 parents of children with ABI were eligible for review. Compared with usual care or active comparator, parent training was associated with significant reduction in parent stress (four RCTs; standardized mean difference [SMD], − 0.32 on a numerical rating scale [95% CI, − 0.60, − 0.05]; I -squared = 7.5%, p = 0.356); significant reduction in parent depression (three RCTs; SMD, − 0.43 [95% CI, − 0.72, − 0.14]; I -squared = 0.0%, p = 0.393); and significant reduction in parent anxiety (two RCTs; SMD, − 0.63 [95% CI, − 1.05, − 0.21]; I -squared = 0.0%, p = 0.629). Overall risk of bias was high for randomization process (one RCT), missing outcome data (three RCTs), measurement of the outcome (three RCTs), and selection of reported result (two RCTs). Heterogeneity between studies by country of study origin was not significant. Conclusions Compared with usual care or an active comparator, parent training was associated with short-term reduction in stress, depression, and anxiety in parents of children with ABI. Future clinical trials of parent interventions are needed as there may be some short-term beneficial effects. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-022-00399-9.

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“…For this reason, such a program offers the opportunity to fill a gap in outpatient rehabilitation support in Italy, while mitigating geographical and economical barriers to care, which have previously limited outpatient rehabilitation offered by the Italian National Health Care Service. Moreover, as the intervention has been developed for patients with TBI and subsequently adapted for other neurological populations, such as epilepsy or pediatric brain tumor (Modi et al, 2017; Raj, Shultz et al, 2018), it seems to represent a promising treatment opportunity for children with ABI that, as reported above, often fail to receive the recommended dose of rehabilitation for optimal recovery.…”

Section: Introductionmentioning

confidence: 99%

Adapting intervention approaches to new contexts: Three case studies of international adaptation of the Teen Online Problem Solving (TOPS) program.

Wade¹,

Jones²,

Corti³

et al. 2021

Rehabilitation Psychology

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Purpose/Objective: To describe the process of adapting the evidence-based Teen Online Problem Solving (TOPS) program, a telehealth problem-solving treatment addressing executive function and behavior regulation challenges in adolescents with traumatic brain injury, in Italy, New Zealand, and the United Kingdom.Research Method/Design: We describe the process of adapting and translating the TOPS program in three case studies with unique methods and samples. In Italy, 14 parents of adolescents with TBI participated in focus groups and two adolescents with TBI and their parents and two physicians provided input on the resulting translation. In New Zealand, an independent Māori cultural advisor reviewed the content, and six adolescent-parent dyads and two health professionals completed the 10 modules independently over a five-week period to inform adaptation. In the United Kingdom, a team of neuropsychologists and a parent of an adolescent with ABI reviewed and adapted the content through successive iterations.Results: In Italy, suggested changes included greater emphasis on nonverbal communication and clearer examples of inappropriate problem-solving responses. In New Zealand, parents and adolescents rated the program as acceptable and helpful. Suggestions included incorporating familiar Māori settings, integrating religion, and developing videos with New Zealand adolescents. In the United Kingdom, iterative refinements focused on adapting TOPS for other acquired brain injuries and reflecting cross-national differences (e.g., drinking age).Conclusions/Implications: These three case studies suggest that programs such as TOPS developed in one cultural context can be broadly acceptable in other contexts, with adaptations focusing on tailoring to reflect the unique cultural and linguistic setting.

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Effects of Web-Based Parent Training on Caregiver Functioning Following Pediatric Traumatic Brain Injury: A Randomized Control Trial

Abstract: I-InTERACT reduced caregiver depression but no other facets of caregiver psychological functioning. Modifications to the treatment content may be necessary to reduce parenting stress and improve caregiver efficacy.

Cited by 12 publications

References 32 publications

Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence

Effectiveness of Training Programs for Reducing Adverse Psychological Outcomes in Parents of Children with Acquired Brain Injury: A Systematic Review and Meta-Analysis

Adapting intervention approaches to new contexts: Three case studies of international adaptation of the Teen Online Problem Solving (TOPS) program.

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