Megan E Narad1, Stacey Raj2, Keith O Yeates3, H Gerry Taylor4, Michael W Kirkwood5, Terry Stancin6, Shari L Wade2. 1. Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address: megan.narad@cchmc.org. 2. Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. 3. Department of Psychology, Alberta Children's Hospital Research Institute Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 4. Biobehavioral Health Center, Nationwide Children's Hospital Research Institute, Department of Pediatrics, The Ohio State University, Columbus, Ohio. 5. Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colorado. 6. Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio.
Abstract
OBJECTIVE: To examine parent and family outcomes of a randomized controlled trial (RCT) comparing Teen Online Problem-Solving with Family (TOPS-F), Teen Online Problem-Solving-Teen Only (TOPS-TO), or access to Internet resources alone (Internet resource comparison [IRC]). DESIGN: Three-arm RCT. SETTING:Four children's hospitals and 1 general medical center in Ohio and Colorado. PARTICIPANTS: Children and adolescents (N=152), 11-18 years old, hospitalized for complicated mild to severe traumatic brain injury in the previous 18 months. INTERVENTIONS: Intervention groups: TOPS-F, TOPS-TO, and IRC. MAIN OUTCOME MEASURE: Parental depression (CES-D), parental psychological distress (SCL-90-GSI), family functioning (FAD-GF), cohesiveness (PARQ), and conflict (IBQ) were assessed pre- and post-treatment. Treatment effects and the moderating effect of the number of parents in the home (single vs 2-parent families). RESULTS: Number of parents moderated treatment effects with effects ranging from trending to statistically significant for depression, family functioning, cohesion, and conflict. Among single parents, TOPS-TO reported better family functioning than TOPS-F and greater cohesion and less conflict than IRC. Among 2-parent families, TOPS-F reported less depression than IRC and less depression and greater cohesion than TOPS-TO. The effect of family composition was also noted within TOPS-TO and TOPS-F. In TOPS-F, 2-parent families reported less depression than single-parent families. In TOPS-TO single parents reported greater cohesion and better family functioning than 2-parent families. CONCLUSIONS: Findings support the TOPS intervention improves family outcomes, with differential effects noted for single vs 2-parent households. The TOPS-TO format appeared more beneficial for single-parent households, while TOPS-F was more beneficial for 2-parent households, highlighting the importance of considering family composition when determining the best treatment modality.
RCT Entities:
OBJECTIVE: To examine parent and family outcomes of a randomized controlled trial (RCT) comparing Teen Online Problem-Solving with Family (TOPS-F), Teen Online Problem-Solving-Teen Only (TOPS-TO), or access to Internet resources alone (Internet resource comparison [IRC]). DESIGN: Three-arm RCT. SETTING: Four children's hospitals and 1 general medical center in Ohio and Colorado. PARTICIPANTS: Children and adolescents (N=152), 11-18 years old, hospitalized for complicated mild to severe traumatic brain injury in the previous 18 months. INTERVENTIONS: Intervention groups: TOPS-F, TOPS-TO, and IRC. MAIN OUTCOME MEASURE: Parental depression (CES-D), parental psychological distress (SCL-90-GSI), family functioning (FAD-GF), cohesiveness (PARQ), and conflict (IBQ) were assessed pre- and post-treatment. Treatment effects and the moderating effect of the number of parents in the home (single vs 2-parent families). RESULTS: Number of parents moderated treatment effects with effects ranging from trending to statistically significant for depression, family functioning, cohesion, and conflict. Among single parents, TOPS-TO reported better family functioning than TOPS-F and greater cohesion and less conflict than IRC. Among 2-parent families, TOPS-F reported less depression than IRC and less depression and greater cohesion than TOPS-TO. The effect of family composition was also noted within TOPS-TO and TOPS-F. In TOPS-F, 2-parent families reported less depression than single-parent families. In TOPS-TO single parents reported greater cohesion and better family functioning than 2-parent families. CONCLUSIONS: Findings support the TOPS intervention improves family outcomes, with differential effects noted for single vs 2-parent households. The TOPS-TO format appeared more beneficial for single-parent households, while TOPS-F was more beneficial for 2-parent households, highlighting the importance of considering family composition when determining the best treatment modality.
Authors: Shari L Wade; Kelly M Jones; Claudia Corti; Anna R Adlam; Jennifer Limond; Alessandra Bardoni; Lisa M Gies Journal: Rehabil Psychol Date: 2021-11
Authors: Linda Ewing-Cobbs; Janelle J Montroy; Amy E Clark; Richard Holubkov; Charles S Cox; Heather T Keenan Journal: Front Neurol Date: 2021-07-05 Impact factor: 4.003