A Scalable mHealth Resource to Facilitate Behavioral and Emotional Recovery after Pediatric Traumatic Injury

项目总结/文摘

PROJECT SUMMARY/ABSTRACT Pediatric traumatic injury (PTI) is a public health priority, with nearly 300,000 children incurring injuries so severe that they require hospitalization each year. PTI is associated with annual individual and societal costs of $87 billion and elevates risk for posttraumatic stress, depression, and other health risk consequences that affect quality of life, physical recovery, emotional and behavioral outcomes, family roles and routines, and academic functioning. Follow-up care for affected children and caregivers is critical to support behavioral and emotional recovery, but few trauma centers provide these services and established, scalable models of care are lacking. Cost-effective, sustainable interventions are needed to reduce barriers to care and reach families that need it most. Pilot data collected by the candidate suggest that a technology-enhanced model of care is appealing to caregivers and has high potential to address service barriers by providing real-time assistance to help caregivers manage their own distress and their children’s behavioral and emotional recovery. The candidate proposes to develop and systematically evaluate CAARE (Caregivers’ Aid to Accelerate Recovery after pediatric Emergencies), an intervention informed by our ongoing clinical initiatives together with results of qualitative semi-structured interviews with caregivers of young children after PTI. CAARE will consist of education, self-monitoring, and coping resources. Specific aims include: 1) finalize the CAARE model and research protocol with ~15 caregivers after PTI; 2) pilot test CAARE via an open trial (n=60); and 3) assess CAARE implementation feasibility with families (n~20), trauma center directors (n~15), and program managers (n~15). The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in child traumatic stress research. Dovetailing with the research aims, K23 training objectives are to: 1) develop proficiency in clinical trial design, implementation, and evaluation; 2) enhance proficiency in the use of iterative-design technology-based solutions; 3) develop expertise in implementation science; 4) enhance statistical training in clinical trials, longitudinal analyses, and qualitative data analysis; and 5) expand skills in scientific communication, including grant writing, presentations, and publications. Mentorship and consultation from experts in pediatric trauma, health technology solutions, implementation science, and advanced statistics will ensure training goals are met. The candidate’s long-term career goal is to establish a research portfolio that develops, rigorously tests, and scales innovative, cost-efficient, evidence-based health technology resources to improve access and quality of care for trauma-impacted families in real-world settings. These research and training goals directly correspond with priorities detailed in NICHD’s Pediatric Trauma and Critical Illness Branch, and will allow the candidate to become an internationally recognized leader in child and family trauma prevention and treatment research. The training proposed herein is designed to develop expertise in this area, represents a clear progression from prior training, and would not be possible without this K23.