Moderate to severe traumatic brain injury (TBI) in children is a significant family stressor resulting in increased caregiver burden, impaired psychological adjustment among caregivers, and deteriorating family functioning. Empirically based interventions for families following TBI are virtually nonexistent, and access to skilled therapists may be restricted by distance and finances. The current project seeks to address these needs by developing and piloting an innovative on-line intervention for families of children with TBI. The intervention will be adapted for the World Wide Web from a recently developed program integrating an established problem-solving protocol with training in TBI- specific behavior management strategies. The proposed study will develop the on-line intervention materials and test them in a small randomized, controlled trial comparing the effects of standard care plus Internet access to standard care plus the on-line family intervention on the following outcomes: 1) problem-solving and communication skills; 2) injury-related stress and burden; 3) caregiver psychological distress; and 4) parent-child conflict. Participants will include the families of children, aged 6 - 14, who have experienced a moderate to severe TBI between 3 and 15 months prior to study participation. All families will be given a computer, modem, and Internet access to reliable brain injury information sites on the Web and randomly assigned to a treatment group. Group differences will be examined using a multivariate approach to analysis of covariance, controlling for injury severity, child's age, SES, and time since injury. We hypothesize better problem solving and communication skills, less injury-related stress, better caregiver functioning, and less parent-child conflict among the intervention group compared to the standard care group. This family-centered intervention program makes use of emerging technology to address the complex needs of families following TBI with the goal of reducing psychological distress in caregivers, thereby enabling the family to optimally support the child's recovery from TBI.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HD040942-03
Application #
6615813
Study Section
Special Emphasis Panel (ZHD1-RRG-K (16))
Program Officer
Quatrano, Louis A
Project Start
2001-09-01
Project End
2005-07-31
Budget Start
2003-08-01
Budget End
2005-07-31
Support Year
3
Fiscal Year
2003
Total Cost
$202,826
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Carey, Joanne C; Wade, Shari L; Wolfe, Christopher R (2008) Lessons learned: the effect of prior technology use on Web-based interventions. Cyberpsychol Behav 11:188-95
Gfroerer, Susan Davies; Wade, Shari L; Wu, Michelle (2008) Parent perceptions of school-based support for students with traumatic brain injuries. Brain Inj 22:649-56
Wade, Shari L; Wolfe, Christopher; Brown, Tanya Maines et al. (2005) Putting the pieces together: preliminary efficacy of a web-based family intervention for children with traumatic brain injury. J Pediatr Psychol 30:437-42
Wade, Shari L; Wolfe, Christopher R; Pestian, John P (2004) A web-based family problem-solving intervention for families of children with traumatic brain injury. Behav Res Methods Instrum Comput 36:261-9