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Awarded Grant - Acute Care

A Trial of Two Online Interventions for Child Brain Injury

FOA Number: CE03-023 - Grants for Acute Care, Rehabilitation and Disability ResearchProject Period: 09/30/03–09/29/06
Application/Grant Number: 1-R49-CE523224-01
Principal Investigator: Shari L. Wade, PhD
Cincinnati Children’s Hospital Medical Center
Division of Pediatric Rehabilitation
3333 Burnet Avenue
Cincinnati, OH 45229-3039
Phone: 513-636-7480
Fax: 513-636-7360


Moderate to severe traumatic brain injury (TBI) in children is a significant family stressor and results in increased caregiver burden, impaired psychological adjustment among caregivers, and deteriorating family functioning. Empirically based interventions to address family needs following TBI are limited, and access to skilled therapists can be restricted by distance and finances. This project seeks to address these needs by testing the efficacy of two contrasting models of online intervention for families of children with moderate to severe TBI: individualized online Family Problem Solving Therapy (FPS) and online Case Management and Multi-Family support group (CM). Although both aim to reduce caregiver stress and burden, the treatments have different primary targets (FPS uses cognitive appraisals and problem solving; CM provides information and support). Treatments also differ in intensity of therapeutic contact and cost of implementation.

This study will examine the efficacy of these two online treatments in a randomized trial comparing the effects of FPS and CM to the effects of standard care (SC). Primary outcomes include problem-solving skills, injury-related stress and burden, caregiver depression and anxiety, and parenting stress. Participants will include the families of children ages 5 to 16 who have experienced a moderate to severe TBI between 1 and 12 months before study participation. Families will be randomly assigned to one of three conditions: FPS, CM, or SC. Group differences will be examined using a multi-variety approach to analysis of covariance, controlling for injury severity, child's age, sociodemographic status, and time since injury. It is hypothesized that there will be less injury-related stress, lower levels of anxiety and depression, and less parenting stress in the two intervention groups than in the standard care group and that FPS will be associated with better outcomes than will CM in families with high levels of child-related stress and family dysfunction at baseline. The overarching goal is to identify effective treatments for reducing psychological distress in caregivers, enabling the family to optimally support the child's recovery from TBI.