Building and testing feasibility of EMPOWER, a skill-based psychosocial intervention for parents of critically ill children

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PROJECT SUMMARY Surviving a serious, life-threatening illness in the pediatric intensive care unit (PICU) often comes at the cost of new child morbidity and detriments to child and parent mental health. Parents are integral in a child’s PICU recovery. Yet, parent mental health and caregiver self-efficacy can be significantly and negatively impacted by the trauma associated with a child’s PICU admission, affecting parents’ ability to help their child optimally recover. Recognizing the key role of parents in child health, the National Academy of Medicine has identified a crucial need for psychosocial interventions for parents in vulnerable situations, such as PICU admission. However, a recent systematic review found a paucity of parent interventions in the PICU. Thus, a critical need exists for an effective psychosocial intervention for PICU parents that reduces PTSS and enhances caregiver self-efficacy after discharge. The overall objective of this proposal is to gain the skills to build and test the feasibility of a theory-driven and evidence-based parent psychosocial intervention through three specific aims: Aim 1) Build EMPOWER, an intervention for parents whose children are admitted to a PICU. Dr. Yagiela will collaborate with PICU stakeholders and use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework to integrate and adapt evidence-based components from existing parent interventions to create EMPOWER. Aim 2) Develop and test a training curriculum to prepare parent mentors to deliver the EMPOWER intervention. Principles of adult learning, didactics, role-playing exercises, and delivery of the intervention in standardized scenarios will be used to train and test the readiness of parent mentors to deliver the intervention. Aim 3) Determine the feasibility, acceptability, and implementation factors of the EMPOWER intervention. Parent mentors will deliver the intervention to PICU parents in a feasibility trial. The expected outcome of these aims is a feasible theory-driven and evidence-based intervention called EMPOWER, that helps parents gain skills to reduce immediate distress, which my conceptual model posits can reduce future PTSS and enhance caregiver self-efficacy. This is expected to have a positive impact by improving parents’ ability to support their child’s recovery, thereby increasing the potential for improved PICU child outcomes. This K23 proposal also includes a four-year training plan. With the support of an expert team of mentors and advisors, Dr. Yagiela will gain training in developing behavioral interventions, designing and conducting clinical trials, and qualitative and mixed methods, and develop professionally. The training goals will be accomplished through frequent interaction with mentors / advisors, didactic coursework, mentored study, seminars, and conferences. This K23-supported data and training will provide a foundation for a future R01-funded randomized controlled trial of the EMPOWER intervention and enable Dr. Yagiela to achieve her long-term goal of becoming an independent clinician-researcher who develops, tests, and implements psychosocial interventions that improve mental and physical health outcomes in parents and critically ill children.