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Link for Injured Kids and Trauma Education: A Comparative Effectiveness Study of Two Parent-Based Interventions to Support Children After Traumatic Injury

28 Pages Posted: 2 Dec 2020

See all articles by Marizen R. Ramirez

Marizen R. Ramirez

University of Iowa

Javier E. Flores

University of Iowa

Briana Woods-Jaeger

Children’s Mercy Hospital

Joe Cavanaugh

University of Iowa

Corinne Peek-Asa

University of Iowa

Cassidy Branch

University of Iowa

Mallory Bolenbaugh

University of Iowa

Vidya Chande

Blank Children's Hospital

Graeme Pitcher

University of Iowa

Henry W. Ortega

Children’s Hospitals and Clinics of Minnesota

Kimberly A. Randell

Children’s Mercy Hospital

Kristel Wetjen

University of Iowa

Lisa Roth

University of Iowa

Justin Kenardy

University of Queensland

More...

Abstract

Background: A comparative effectiveness trial tested two parent-based interventions in improving the psychosocial recovery of hospitalized injured children: 1) Link for Injured Kids (Link), a program of psychological first aid that teaches parents motivational interviewing and stress screening skills, and 2) Trauma Education, based on an informational booklet about trauma, its impacts and resources.

Methods: A randomized controlled trial was conducted in four children’s hospitals in the Midwestern United States. 10-17 year old children admitted for an unintentional injury and a parent were recruited and randomly assigned to Link or Trauma Education between 1/2015-7/2017. Link parents were trained in motivational interviewing based communication and screening skills; Trauma Education parents received an educational booklet. Parents and children completed questionnaires at baseline, six weeks, three months, and six months post-hospitalization. Using an intent to treat analysis, changes in child-reported symptoms of posttraumatic stress (PTSS), depression, quality of life and child behaviors were compared between intervention groups.  This study is registered at ClinicalTrials.gov (ID: NCT02323204, Unique Protocol ID: 201111728). The trial is currently closed.

Findings: Of 795 injured children, 314 children and their parents were enrolled into the study (40%). Link and Trauma Education improved PTSS, depression and pediatric quality of life at similar rates over time. However, unlike those in Trauma Education, children in the Link group had notable improvement of child emotional behaviors, and mild improvement of conduct and peer behaviors.  Link was also slightly more effective than Trauma Education in improving conduct behaviors in rural compared to urban children.

Interpretation: Although both programs improved post-trauma symptoms, Link, which interacted with parents to teach communication and referral skills, was more effective in reducing problem behaviors.

Trial Registration: This study is registered at ClinicalTrials.gov (ID: NCT02323204, Unique Protocol ID: 201111728).

Funding Statement: The Patient-Centered Outcomes Research Institute (PCORI) funded this research.

Declaration of Interests: All authors have no reported conflicts of interest.

Ethics Approval Statement: Study procedures conducted at the University of Iowa Stead Family Children’s Hospital and Children’s Mercy Hospital Kansas City were approved by the University of Iowa Institutional Review Board (IRB ID# 201111728, reliance IRB#: 14110518). Study procedures conducted at Blank Children’s Hospital and Children’s Minnesota were approved by their respective Institutional Review Boards (ID number IM2014-029, IRB number 1602-010).

Keywords: Wounds and Injuries, Stress Disorders, Post-Traumatic, hospitalization

Suggested Citation

Ramirez, Marizen R. and Flores, Javier E. and Woods-Jaeger, Briana and Cavanaugh, Joe and Peek-Asa, Corinne and Branch, Cassidy and Bolenbaugh, Mallory and Chande, Vidya and Pitcher, Graeme and Ortega, Henry W. and Randell, Kimberly A. and Wetjen, Kristel and Roth, Lisa and Kenardy, Justin, Link for Injured Kids and Trauma Education: A Comparative Effectiveness Study of Two Parent-Based Interventions to Support Children After Traumatic Injury. Available at SSRN: https://ssrn.com/abstract=3731424 or http://dx.doi.org/10.2139/ssrn.3731424

Marizen R. Ramirez (Contact Author)

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Javier E. Flores

University of Iowa

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Briana Woods-Jaeger

Children’s Mercy Hospital ( email )

Kansas City, MO
United States

Joe Cavanaugh

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Corinne Peek-Asa

University of Iowa

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Cassidy Branch

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Mallory Bolenbaugh

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Vidya Chande

Blank Children's Hospital ( email )

Graeme Pitcher

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Henry W. Ortega

Children’s Hospitals and Clinics of Minnesota ( email )

Kimberly A. Randell

Children’s Mercy Hospital ( email )

Kansas City, MO
United States

Kristel Wetjen

University of Iowa ( email )

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Lisa Roth

University of Iowa

341 Schaeffer Hall
Iowa City, IA 52242-1097
United States

Justin Kenardy

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

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