A Qualitative Exploration of Post-Injury Challenges and the Potential Role of the PTSD Coach Mobile Application to...

Digital interventions designed to prevent development of chronic pain and comorbid mental health symptoms, specifically targeting the acute injury recovery period, are in the early stages of development. The evidence-based PTSD Coach mobile application is a free resource offering cognitive-behavioral interventions to self-manage posttraumatic symptoms; it is used widely in varied populations, and it is feasible and acceptable to injured Emergency Department patients. However, patients' subjective experience and feedback regarding optimizing the app are lacking.

We conducted a qualitative study in which we recruited and interviewed 18 acutely injured adult patients (5 men; 13 women) at-risk for persistent pain and psychological problems. Participants were instructed to use PTSD Coach for at least 1 week; during the interview, participants discussed post-injury needs and challenges, their experience with the app, and general perceptions of its suitability to address post-injury distress.

Favorable feedback centered on the variety of user-friendly tools to help manage symptoms, ability to increase awareness of symptoms and identify and cope with distressing reminders of the trauma, and on facilitating openness and linking to resources for mental health treatment. Suggestions for improvement included: increased personalization through app onboarding, text messages and other notifications to prompt use, having voice-overs to read content to participants, and linkages to in-person mental healthcare if needed.

These findings support PTSD Coach as a potential self-management tool to prevent the chronicity of maladaptive psychological reactions to injury and highlight features that may improve its utility for this unique underserved population.