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A pilot randomized controlled trial assessing secondary prevention of traumatic stress integrated into pediatric
Nancy Kassam-Adams1, J Felipe García-España, Meghan L Marsac
1Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. nlkaphd@mail.med.upenn.edu
Insights
A pilot study found that a targeted intervention did not reduce posttraumatic stress disorder (PTSD) or depression in injured children. While both groups improved, 10% still had PTSD at 6 months, indicating a need for better pediatric injury care.
Area of Science:
- Pediatric trauma care
- Mental health interventions
- Secondary injury prevention
Background:
- Medical settings offer opportunities for secondary prevention of traumatic stress in pediatric injury.
- Posttraumatic stress disorder (PTSD) and other sequelae can affect injured children.
- A targeted preventive intervention integrated into acute medical care was evaluated.
Purpose of the Study:
- To evaluate the delivery and effectiveness of a targeted preventive intervention for hospitalized injured children at risk for PTSD.
- To compare the intervention group with a usual care group.
Main Methods:
- A pilot randomized trial was conducted with hospitalized injured children.
- Children at risk for PTSD were identified through screening (N=85).
- Participants were randomized to either the intervention (n=46) or usual care (n=39).
Main Results:
- The preventive intervention did not significantly reduce PTSD or depression severity compared to usual care.
- Health-related quality of life was not increased in the intervention group.
- At 6 months post-injury, approximately 10% of participants in both groups still met PTSD criteria.
Conclusions:
- The tested preventive intervention, integrated into acute medical care, did not improve outcomes for injured children at risk for PTSD.
- Significant improvements were observed in both groups over time, but PTSD remained an issue for a subset of children.
- There is a need for enhanced comprehensive pediatric injury care to further address the mental health sequelae of trauma.
Abstract:
Medical settings provide opportunities for secondary prevention of traumatic stress and other sequelae of pediatric injury. This pilot randomized trial evaluated the delivery and effectiveness of a targeted preventive intervention based on best practice recommendations and integrated within acute medical care. Hospitalized injured children were screened for risk of developing posttraumatic stress disorder (PTSD). Those at risk (N = 85) were randomized to the intervention (n = 46) or usual care (n = 39). The preventive intervention did not reduce PTSD or depression severity or increase health-related quality of life, compared to usual care. Both groups improved over time, but 6 months postinjury approximately 10% of each group still met criteria for PTSD, suggesting room for improvement in comprehensive pediatric injury care.
