Research Reports - Effects of web-based parent training on caregiver functioning Following Pediatric Traumatic Brain Injury

Raj, Stacey, P.; Shultz, Emily, L.; Zang, Huaiyu; Zhang, Nanhua; Kirkwood, Michael, W.; Taylor, H., Gerry; Stancin, Terry; Yeates, Keith, Owen; Wade, Shari, L.

The Journal of Head Trauma Rehabilitation: March 29, 2018

Objective: To examine the effects of a Web-based parenting intervention (I-InTERACT), and an abbreviated version (Express), on caregiver depression, psychological distress, parenting stress, and parenting efficacy following pediatric traumatic brain injury (TBI).

Setting: Four children's hospitals and 1 general hospital in the United States.

Participants: 148 caregivers of 113 children aged 3 to 9 years with a moderate to severe TBI.

Design: Multicenter randomized controlled trial. Participants were randomly assigned to I-InTERACT, Express, or an active control condition. Caregiver data were collected at baseline and postintervention (6 months later).

Intervention: I-InTERACT (10-14 sessions) and Express (7 sessions) combine live coaching of parenting skills and positive parenting strategies.

Main Measures: Center for Epidemiologic Studies Depression Scale (CES-D); Global Severity Index of the Symptom Checklist-90-R (GSI), Parenting Stress Index (PSI), and Caregiver Self-Efficacy Scale (CSES).

Results: Analyses revealed no main effects of treatment on caregiver distress (GSI), parenting stress (PSI), or parenting efficacy (CSES). However, analyses examining baseline severity as a moderator found that caregivers with elevated levels of depression in I-InTERACT experienced significantly greater reductions in CES-D scores compared with caregivers in the active control condition.

Conclusions: I-InTERACT reduced caregiver depression but no other facets of caregiver psychological functioning. Modifications to the treatment content may be necessary to reduce parenting stress and improve caregiver efficacy.

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