About 4000 children per year are stressed when one of their parents is murdered by the other parent, at least as many as are affected by leukemia per year. At this time, there is no tested intervention available for these children or the families struggling to care for them. Intraparental homicide (IPH) is a particularly devastating trauma and stressor for children. In a single act, children usually lose both parent to either death, prison or both. While there are few studies of this phenomenon, the available data indicate that children experience substantial short- and long-term mental health consequences such as post traumatic stress disorder (PTSD). Findings from prior research by this team indicate that guardians of these children did not know how to help the children. The guardians experience significant stress and disruption in their families, demanding new coping abilities and new support in order for them to adapt. The investigators are completing a study (R01- NR008532) that describes the experiences of these children. The present study builds on the findings of that study. Exhaustive searches of the scientific and clinical literature have uncovered no interventions directed toward these guardians. The present proposal is to test an interactive health communication application (IHCA) as a way of providing information and support to the guardians of these child survivors of IPH. Use of IHCA has been found to be effective for a variety of other health conditions (Murray, Burns, See Tai, Lai, & Nazareth, 2005) such as women with breast cancer and children with asthma and their parents. The IHCA program to be used here will consist of the following components: an Instant Library of articles on topics of interest to these guardians; a resource directory (descriptions and contact information, including web links) of national and local organizations providing victim services, mental health services, parenting support, legal services, faith-based, drug and alcohol, etc. and other organizations; limited access asynchronous chat, allowing for peer-to-peer support in a safe and anonymous format; `Ask an Expert' with expert responses to user questions; and personal stories, text accounts of how others have experienced caring for children bereaved by IPH. The researchers will first refine the IHCA using focus group interviews with guardians of children bereaved by IPH. They will then randomly assign guardians of children bereaved by IPH to the IHCA intervention vs open computer internet use (63 in each group) to determine if the guardians using the IHCA have greater `parenting' capabilities and less `parenting' stress and if the children experience improved behavior and mental health. These findings will then be used at the termination of this project to design a larger, phase III, randomized clinical trial to test the efficacy of this guardian intervention vs. resources available through open internet usage. Project Narrative About 4000 children each year are bereaved by intraparental homicide (IPH) each year, and there are about 70,000 such stressed children currently in the US. The mental health and behavioral consequences of this stress are substantial. These children are disproportionately African American, making this a source of health disparity as well. This proposal therefore offers an opportunity to address both an understudied topic (NINR, 2007) and a substantial health disparity. ? ? ?
