Road-to-Recovery-TBI: Pilot Trial of an eHealth Intervention for Caregivers After Pediatric Brain Injury

Abstract

Objective: Traumatic brain injury (TBI) is a leading cause of acquired disability in childhood, impacting long-term health and functioning. Caregivers of children with TBI report worsening psychological health—and caregiver functioning and behaviors directly impact child recovery and outcomes. We developed and pilot tested road-to-recovery-TBI (R2R-TBI), a self-guided, eHealth intervention to support caregivers during the acute phase following pediatric TBI and equip families with skills to promote a positive path to recovery. Method: Caregivers of children hospitalized for moderate-to-severe TBI were recruited within 3 months postinjury. Twenty primary caregivers completed measures assessing caregiver psychological functioning, family functioning, and child behavior prior to accessing the intervention and at follow-up 1 month later. Caregivers also completed postintervention satisfaction and usability surveys. Results: Thirty of 42 eligible caregivers consented to participate. Caregivers were diverse with regard to race/ethnicity (45% non-White), income (65% receiving public assistance), and child age (1 month to 15 years). All caregivers rated the intervention as helpful and 90% reported making positive changes. While average scores were in the nonclinical range at baseline and follow-up, percentages of caregivers reporting clinically elevated challenges across all measures (15% to 50%) were higher than instrument norms. There were no significant changes in caregiver, family, or child outcomes from baseline to follow-up. Conclusions: Given challenges that caregivers experience accessing in-office interventions that target their well-being and/or parenting, the R2R-TBI program may be a cost-effective and accessible approach to supporting families during a challenging phase of recovery. Further research is needed to examine the efficacy of the intervention.

Implications for Impact Statement

We developed and pilot tested road-to-recovery-traumatic brain injury (R2R-TBI), a self-guided, eHealh intervention to support caregivers during the stressful and challenging acute phase following pediatric TBI and equip families with skills to promote a positive path to recovery. Caregivers in this pilot trial reported good satisfaction with intervention, though no overall changes in caregiver, family, or child functioning were noted between baseline and 1-month follow-up. With further efficacy trials, the R2R-TBI intervention may have promise as a form of preventative behavioral health care for children and families in the acute phase of pediatric TBI.