Evaluation of a trauma center-based, technology enhanced stepped care intervention to promote the mental health recovery of adolescent traumatic injury survivors

IF 1.4 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Contemporary Clinical Trials Communications Pub Date : 2026-04-01 Epub Date: 2026-02-24 DOI:10.1016/j.conctc.2026.101622

Tatiana M. Davidson , Theresa Skojec , Priscilla Li , Leigh E. Ridings , Hannah Espeleta , Sarah German , Martina Mueller , Robert Gates , David Mooney , Robert Russell , Terri deRoon-Cassini , Kenneth Ruggiero

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引用次数: 0

Abstract

Background

Pediatric traumatic injury (PTI) is a leading cause of hospitalization and long-term morbidity among U.S. youth, with approximately 30% developing posttraumatic stress or depression. Despite clear mandates from the American College of Surgeons (ACS) for behavioral health screening and referral, few pediatric trauma centers have the infrastructure to deliver coordinated mental health care. The Trauma Resilience and Recovery Program (TRRP) is a stepped-care, technology-enhanced model designed to promote psychological recovery following injury. This study evaluates the effectiveness of TRRP and identifies factors influencing its integration within pediatric trauma settings.

Chods

This multi-site, Type I hybrid effectiveness–implementation trial will recruit 300 adolescents (ages 12–17) hospitalized for traumatic injury and their caregivers across three pediatric trauma centers. Participants are randomized to TRRP or Enhanced Usual Care (EUC). TRRP includes bedside psychoeducation, risk screening, a brief coping skills intervention, automated text-based symptom monitoring, 30-day follow-up screening, and referral to evidence-based mental health care as needed. Primary outcomes (PTSD, depression, quality of life) are assessed at baseline, 3, 6, and 12 months. Qualitative interviews with families and trauma personnel, guided by the Consolidated Framework for Implementation Research (CFIR), will explore barriers and facilitators to implementation. Quantitative data will be analyzed using mixed-effects models; qualitative data will undergo thematic analysis.

Conclusions

This study will provide critical evidence on the clinical effectiveness and real-world integration of TRRP for adolescent trauma survivors. Findings will inform a scalable roadmap for embedding evidence-based behavioral health care into pediatric trauma systems to improve recovery and long-term well-being.

Clinicaltrials.gov idNCT05086757.

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评估创伤中心为基础，技术加强阶梯式护理干预，以促进青少年创伤幸存者的心理健康恢复。

背景：儿童创伤性损伤（PTI）是美国青少年住院和长期发病的主要原因，其中约30%的青少年发展为创伤后应激或抑郁症。尽管美国外科医师学会（American College of Surgeons， ACS）明确要求进行行为健康筛查和转诊，但很少有儿科创伤中心具备提供协调一致的精神卫生保健的基础设施。创伤恢复力和恢复计划（TRRP）是一个阶梯式护理，技术增强的模型，旨在促进受伤后的心理恢复。本研究评估TRRP的有效性，并确定影响其在儿科创伤设置整合的因素。方法：这项多地点、I型混合有效性实施试验将招募300名因创伤性损伤住院的青少年（12-17岁）及其护理人员，他们来自三个儿科创伤中心。参与者被随机分配到TRRP或增强常规护理（EUC）组。TRRP包括床边心理教育，风险筛查，简短的应对技能干预，基于文本的自动症状监测，30天的随访筛查，以及根据需要转介到循证精神卫生保健。主要结局（PTSD、抑郁、生活质量）在基线、3、6和12个月进行评估。在实施研究综合框架（CFIR）的指导下，对家庭和创伤人员进行定性访谈，探讨实施的障碍和促进因素。定量数据将使用混合效应模型进行分析；将对定性数据进行专题分析。结论：本研究将为青少年创伤幸存者TRRP的临床有效性和现实世界整合提供重要证据。研究结果将为将基于证据的行为卫生保健纳入儿科创伤系统提供可扩展的路线图，以改善康复和长期健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contemporary Clinical Trials Communications Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

2.70

自引率

6.70%

发文量

146

审稿时长

20 weeks

期刊介绍： Contemporary Clinical Trials Communications is an international peer reviewed open access journal that publishes articles pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from a wide range of disciplines including medicine, life science, pharmaceutical science, biostatistics, epidemiology, computer science, management science, behavioral science, and bioethics. Contemporary Clinical Trials Communications is unique in that it is outside the confines of disease specifications, and it strives to increase the transparency of medical research and reduce publication bias by publishing scientifically valid original research findings irrespective of their perceived importance, significance or impact. Both randomized and non-randomized trials are within the scope of the Journal. Some common topics include trial design rationale and methods, operational methodologies and challenges, and positive and negative trial results. In addition to original research, the Journal also welcomes other types of communications including, but are not limited to, methodology reviews, perspectives and discussions. Through timely dissemination of advances in clinical trials, the goal of Contemporary Clinical Trials Communications is to serve as a platform to enhance the communication and collaboration within the global clinical trials community that ultimately advances this field of research for the benefit of patients.