Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial - 21/08/15
, Matthew Price, PhD b, Zachary Adams, PhD c, Kirstin Stauffacher, PhD d, Jenna McCauley, PhD c, Carla Kmett Danielson, PhD c, Rebecca Knapp, PhD c, Rochelle F. Hanson, PhD c, Tatiana M. Davidson, PhD a, Ananda B. Amstadter, PhD e, Matthew J. Carpenter, PhD c, Benjamin E. Saunders, PhD c, Dean G. Kilpatrick, PhD c, Heidi S. Resnick, PhD cAbstract |
Objective |
To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents.
Method |
A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents’ mental health symptoms; BBN plus additional modules targeting parents’ mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression.
Results |
Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = −0.24, SE = 0.08, p < .01) and depressive symptoms (B = −0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = −0.36, SE = 0.19, p = .06; depressive symptoms: B = −0.42, SE = 0.19, p = 0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33).
Conclusion |
Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters.
Clinical trial registration information |
Web-based Intervention for Disaster-Affected Youth and Families; clinicaltrials.gov; NCT01606514.
Le texte complet de cet article est disponible en PDF.Key Words : disaster mental health, technology, posttraumatic stress, depression
Plan
| Clinical guidance is available at the end of this article. |
|
| An interview with the author is available by podcast at www.jaacap.org or by scanning the QR code to the right. |
|
| This research was supported by National Institute of Mental Health (NIMH) Grant R01 MH081056 (PI: Ruggiero). This includes a Diversity supplement awarded to T.M.D. Grant R21 MH086313 (PI: Danielson) also supported some elements of this work. The preparation of this manuscript was supported by NIDA Grant K12DA031794 (PI: Brady; support to J.M., Z.A.) and NIAAA K02AA023239 (PI: Amstadter). All views and opinions expressed herein are those of the authors and do not necessarily reflect those of the funding agency or respective institutions. |
|
| Drs. Price and Knapp served as the statistical experts for this research. |
|
| The authors thank Tiffany Henderson, PhD, at Abt SRBI and Kyleen Welsh, BA, at MUSC for their valuable contributions. The authors also thank Josh Nissenboim, BA, and his staff at Fuzzco for their contributions toward designing and developing Bounce Back Now. |
|
| Disclosure: Drs. Ruggiero, Price, Adams, Stauffacher, McCauley, Kmett Danielson, Knapp, Hanson, Davidson, Amstadter, Carpenter, Saunders, Kilpatrick, and Resnick report no biomedical financial interests or potential conflicts of interest. |
Vol 54 - N° 9
P. 709-717 - septembre 2015 Retour au numéro
Article précédent
- Meta-Assurance: No Tic Exacerbation Caused by Stimulants
- Susan Friedland, John T. Walkup
- Neuromotor Adverse Effects in 342 Youth During 12 Weeks of Naturalistic Treatment With 5 Second-Generation Antipsychotics
- Maren Carbon, Sandeep Kapoor, Eva Sheridan, Aseel Al-Jadiri, Sally Azzo, Tania Sarkaria, John M. Kane, Ema Saito, Christoph U. Correll
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?