Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial

Abstract

Objective To assess the efficacy of Bounce Back Now (BBN), a modular, web-based intervention for disaster-affected adolescents and their parents. Method A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study web portal irrespective of mental health status at baseline. Families who accessed the web portal were assigned randomly to 3 groups: (1) BBN, which featured modules for adolescents and parents targeting adolescents’ mental health symptoms; (2) BBN plus additional modules targeting parents’ mental health symptoms; or (3) assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression. Results Nearly 50% of families accessed the web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B=−0.24, SE=0.08, p<.01) and depressive symptoms (B=−0.23, SE=0.09, p<.01). Post-hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental vs. control conditions at 12-month follow-up (PTSD: B=−0.36, SE=0.19, p=.06; depressive symptoms: B=−0.42, SE=0.19, p=0.03). A time × condition interaction also was found favoring the BBN vs. BBN + parent self-help condition for PTSD symptoms (B=0.30, SE=0.12, p=.02), but not depressive symptoms (B=0.12, SE=0.12, p=.33). Conclusion Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters.

Annual Research Review: Digital health interventions for children and young people with mental health problems – a systematic and meta‐review

“…Four studies evaluated DHIs targeting both anxiety and depression: three evaluated a cCBT intervention (Melnyk et al., ; Sethi, ; Wong, Kady, Mewton, Sunderland, & Andrews, ); the other evaluated a multitheoretical intervention incorporating motivational‐enhancement, cognitive behavioural strategies and behavioural principles (Ruggiero et al., ). A total of 2,173 participants were recruited to these trials; age range 12–25 years, ( M = 17.9, Mdn = 18.5).…”

“…A total of 2,173 participants were recruited to these trials; age range 12–25 years, ( M = 17.9, Mdn = 18.5). Participants were recruited with mild‐to‐moderate anxiety symptoms and/or depression symptoms (Sethi, ), or because they lived in an area which had experienced a significant natural disaster (Ruggiero et al., ). Participants completed the intervention in school (Wong et al., ), or in a community centre or on university campus (Sethi, ).…”

“…Participants completed the intervention in school (Wong et al., ), or in a community centre or on university campus (Sethi, ). The other two interventions were delivered online without specifying a location (Melnyk et al., ; Ruggiero et al., ).…”

“…Evaluation of COPE ( Creating Opportunities for Personal Empowerment ) found no postintervention differences for anxiety and depression symptoms between the intervention and no‐access control (Melnyk et al., ). Finally, a multitheoretical online intervention ( Bounce Back Now ) for adolescents affected by natural disaster resulted in improvements in PTSD and depressive symptoms at 12‐month follow‐up (Ruggiero et al., ).…”

Service needs of adolescent parents in child welfare: Is an evidence-based, structured, in-home behavioral parent training protocol effective?

“…Given that adolescents routinely use, and often prefer, the internet and technology to access health information (Borzekowski & Rickert, 2001; Fox & Duggan, 2013), primary utilization of an in-person intervention may not be the most effective option for adolescents. Recent advances in technology have found web-based interventions to be extremely effective among adolescents for a range of behavioral health issues (Free et al, 2013; Lau, Lau, Wong, & Ransdell, 2011), including high-risk populations such as victims of disaster and interpersonal violence (Ruggiero et al, 2015) and adolescents at high risk for HIV (Noar, Black, & Pierce, 2009). Technological augmentations have been developed for SC in which materials could be delivered via a tablet (Self-Brown et al, 2017) and have recently been used with unique populations, such as fathers (Rostad, Self-Brown, Boyd, Osborne, & Patterson, 2017; Self-Brown et al, 2015).…”