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Pilot Randomized Controlled Trial of a Novel Web-Based Intervention to Prevent Posttraumatic Stress in Children
Nancy Kassam-Adams1, Meghan L Marsac2, Kristen L Kohser3
1Children's Hospital of Philadelphia, University of Pennsylvania, nlkaphd@mail.med.upenn.edu.
Insights
This pilot study found a self-directed online program feasible for preventing persistent posttraumatic stress in children after trauma. Preliminary results suggest a potential medium effect size in reducing symptoms.
Area of Science:
- Child Psychology
- Trauma Studies
- Digital Health Interventions
Background:
- Persistent posttraumatic stress is a significant concern following acute trauma in children.
- Early intervention is crucial for mitigating long-term psychological distress.
- Online interventions offer scalable solutions for pediatric mental health support.
Purpose of the Study:
- To evaluate the feasibility of a self-directed online intervention for preventing persistent posttraumatic stress disorder (PTSD) in children.
- To estimate the effect size of this intervention on posttraumatic stress symptoms.
- To explore factors influencing intervention effectiveness.
Main Methods:
- A pilot randomized controlled trial involving children aged 8-12 years with recent acute medical events.
- Randomization to either a self-directed online intervention or a 12-week waitlist control group.
- Assessment of posttraumatic stress, quality of life, appraisals, and coping at multiple time points.
Main Results:
- The online intervention demonstrated feasibility, with most children engaging and half completing the program.
- Medium effect sizes (d = -.68 to -.55) were observed for reductions in posttraumatic stress severity at 6 and 12 weeks.
- Exploratory analyses indicated greater impact in at-risk children and a smaller effect when initiated later.
Conclusions:
- This pilot randomized controlled trial suggests that a self-directed online intervention is feasible for preventing persistent posttraumatic stress in children.
- Preliminary evidence supports the potential efficacy of this digital approach in mitigating trauma-related symptoms.
- Further research with larger samples is warranted to confirm these findings.
Objective:
To assess feasibility and estimate effect size of a self-directed online intervention designed to prevent persistent posttraumatic stress after acute trauma.
Methods:
Children aged 8-12 years with a recent acute medical event were randomized to the intervention (N = 36) or a 12-week wait list (N = 36). Posttraumatic stress, health-related quality of life, appraisals, and coping were assessed at baseline, 6, 12, and 18 weeks.
Results:
Most children used the intervention; half completed it. Medium between-group effect sizes were observed for change in posttraumatic stress severity from baseline to 6 weeks (d = -.68) or 12 weeks (d = -.55). Exploratory analyses suggest greatest impact for at-risk children, and a small effect for intervention initiated after 12 weeks. Analysis of covariance did not indicate statistically significant group differences in 12-week outcomes.
Conclusions:
This pilot randomized controlled trial provides preliminary evidence that a self-directed online preventive intervention is feasible to deliver, and could have an effect in preventing persistent posttraumatic stress.
