A pilot randomized controlled trial assessing secondary prevention of traumatic stress integrated into pediatric trauma care

Authors

  • Nancy Kassam-Adams,

    Corresponding author
    1. The Children's Hospital of Philadelphia
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
    • Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, 3535 Market St., Suite 1150, Philadelphia, PA 19104
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  • J. Felipe García-España,

    1. The Children's Hospital of Philadelphia
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
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  • Meghan L. Marsac,

    1. The Children's Hospital of Philadelphia
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
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  • Kristen L. Kohser,

    1. The Children's Hospital of Philadelphia
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia
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  • Chiara Baxt,

    1. The Children's Hospital of Philadelphia and Children's Center for OCD and Anxiety
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia and the Children's Center for OCD and Anxiety
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  • Michael Nance,

    1. The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine
    Current affiliation:
    1. Pediatric Trauma Program, The Children's Hospital of Philadelphia and Department of Surgery, University of Pennsylvania School of Medicine
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  • Flaura Winston

    1. The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine
    Current affiliation:
    1. Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, and Department of Pediatrics, University of Pennsylvania School of Medicine
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  • This research was supported by grant R49CE987 from the Centers for Disease Control and Prevention, awarded to Nancy Kassam-Adams. Trial was registered at clinicaltrials.gov (identifier NCT00451282).

Abstract

Medical settings provide opportunities for secondary prevention of traumatic stress and other sequelae of pediatric injury. This pilot randomized trial evaluated the delivery and effectiveness of a targeted preventive intervention based on best practice recommendations and integrated within acute medical care. Hospitalized injured children were screened for risk of developing posttraumatic stress disorder (PTSD). Those at risk (N = 85) were randomized to the intervention (n = 46) or usual care (n = 39). The preventive intervention did not reduce PTSD or depression severity or increase health-related quality of life, compared to usual care. Both groups improved over time, but 6 months postinjury approximately 10% of each group still met criteria for PTSD, suggesting room for improvement in comprehensive pediatric injury care.

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