Teen Online Problem Solving (TOPS) - An Online Intervention Following TBI
Condition: TBI (Traumatic Brain Injury); Brain Edema; Craniocerebral Trauma; Hematoma; Brain Concussion
MeSH terms: Brain Injuries; Brain Injuries, Traumatic; Brain Concussion; Brain Edema; Craniocerebral Trauma; Hematoma
Study type: Interventional

Summary: 
      The purpose of this study is to learn if using the World Wide Web to train teens and their
      families in problem-solving, communication skills, and stress management strategies can help
      them to cope better following traumatic brain injury (TBI). To answer this question, we will
      look at changes from before the intervention to after the intervention on questionnaire
      measures of problem-solving skills, communication, social competence, adjustment, and family
      stress and burden. We hypothesize that families receiving the TOPS intervention will have
      better parent-child communication and problem-solving skills at follow-up than those
      receiving the IRC intervention. Additionally, families receiving the TOPS intervention will
      have lower levels of parental distress, fewer child behavior problems and better child
      functioning than those receiving the IRC intervention. Lastly, treatment effects will be
      moderated by SES and life stresses, such that families with greater social disadvantage will
      benefit more from the TOPS intervention.
    

Detailed description: 
      Traumatic Brain Injury (TBI) creates significant stress for families resulting in increased
      burden, anxiety and depression among family members. Both pre- and post-injury family
      functioning have been linked to child outcomes, suggesting that improvements in family
      adaptation may result in fewer social and behavioral sequelae in the injured child. Despite
      this evidence, the development and evaluation of family interventions following TBI are
      extremely rare.

      Children with TBI are often treated at urban trauma centers then discharged to distant home
      communities where psychosocial follow-up is limited and/or difficult to access. Increasingly,
      the World Wide Web is being used to meet the mental and other health needs of individuals who
      have difficulty accessing care through traditional routes. Given the lack of specialized care
      and follow-up for TBI in many communities, the Web may provide an invaluable tool for linking
      families with state-of-the-art psychosocial care by reducing potential physical and
      psychological barriers (e.g., distance, stigma).

      Building on previous intervention research of the PI, this study targets the adolescent
      population between the ages of 12-18. By identifying the unique concerns and issues of this
      population following brain injury, Teen Online Problem Solving seeks to improve family and
      teen adaptation, thereby reducing social and behavioral sequelae.

      Comparison(s): Teen Online Problem Solving (TOPS) intervention with online curriculum and
      sequential videoconference therapy sessions in addition to usual care, compared to Internet
      Resource Comparison with online access to resources in addition to usual care.
    

Intervention name(s): Teen Online Problem Solving
Intervention type(s): Behavioral
Intervention description(s): We will test the following hypotheses: 1) Children with TBI receiving TOPS will have fewer behavior problems, greater social competence, and better functioning than those receiving IRC at both post-treatment and at a 6-month follow-up assessment. 2) Caregivers of children receiving TOPS will report less depression and psychological distress, less parent-child conflict, and better family functioning than those receiving IRC at both post-treatment and at a 6-month follow-up assessment. 3) Social resources will moderate treatment efficacy, such that children with limited social and economic resources will show greater improvements in the more comprehensive TOPS intervention. We hypothesize better teen problem solving and communication skills, fewer teen emotional/behavioral problems, less parental burden and distress, and less parent-teen conflict at follow-up among the TOPS group compared to the IRC group.
Other intervention name(s): TOPS; IRC
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: TBI (Traumatic Brain Injury); Intracranial Edema; Brain Edema; Craniocerebral Trauma; Head Injury; Brain Hemorrhage, Traumatic; Subdural Hematoma; Brain Concussion; Head Injuries, Closed