1007 Stepped Preventive Care Study

Study Description


1007 Stepped Preventive Care Study


Nancy Kassam-Adams


Flaura Winston and Meghan Marsac


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.
PACT/R Dataset Number


Principal Investigator / Dataset Creator

Nancy Kassam-Adams

Number of assessment points


Study language


PI Institution

Children's Hospital of Philadelphia and University of Pennsylvania

Inclusion criteria

Child age 8 - 17 years admitted to hospital for treatment of an unintentional injury

Exclusion criteria
  • Children with suspected non-accidental, abuse-related injuries or injuries due to intentional, violent acts (e.g., assault).
  • Children and parents who cannot understand spoken English well enough to complete the interview process with reasonable accuracy


2007 - 2008
Geographical Coverage Description

United States


Grant Number
R49 CE000987

US Centers for Disease Control and Prevention (CDC)


Analysis Unit
Analysis Unit

Child exposed to an index potentially traumatic event