1007 Stepped Preventive Care Study

After pediatric injury, PTSD and other psychological sequelae can have significant impact on health and functional outcomes, yet medical providers’ awareness of injury-related traumatic stress is limited. Hospital trauma programs offer unique opportunities for secondary prevention of persistent psychosocial distress and promotion of optimal health outcomes for injured children. Expert consensus recommendations for PTSD prevention call for stepped care incorporating screening, follow-up with those at risk, and evidence-based interventions that are matched to individual need.

This study enrolled children age 8 - 17 years admitted to hospital (urban, Level I Pediatric Trauma Center) for treatment of an unintentional injury. This was a randomized controlled trial comparing Stepped Preventive Care intervention to usual care, with baseline, 6 week, and 6 month assessments. Although the study was an intervention study, the dataset currently excludes all those randomized to the Intervention Condition, and includes those who screened at low risk and were followed, as well as those who screen as at risk and were randomized to Usual Care.

This study had the following specific aims:

1. Evaluate the impact of the intervention on psychosocial outcomes (PTSD and depression symptoms);
2. Evaluate its impact on health outcomes (adherence to discharge instructions, health-related quality of life); 3) Provide preliminary data to inform cost-effectiveness analyses: describe the costs of providing the intervention and describe its impact on subsequent health service utilization.

United States

Child exposed to an index potentially traumatic event