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Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents

Raj, Stacey P. MA; Antonini, Tanya N. MA; Oberjohn, Karen S. MA; Cassedy, Amy PhD; Makoroff, Kathi L. MD; Wade, Shari L. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP; Brenner, Lisa PhD, ABPP

The Journal of Head Trauma Rehabilitation: September/October 2015 - Volume 30 - Issue 5 - p 347–356
doi: 10.1097/HTR.0000000000000052
TBI in Children & Adolescents 2015

Objective: To examine changes in parent depression, psychological distress, parenting stress, and self-efficacy among participants in a randomized trial of a Web-based parent training program for pediatric traumatic brain injury (TBI).

Methods: Primary caregivers of 37 children aged 3 to 9 years who sustained a moderate/complicated mild to severe TBI were randomly assigned to the intervention or control group, and both groups were equipped with home Internet access. The online parent training program was designed to increase positive parenting skills and improve caregiver stress management. It consisted of 10 core sessions and up to 4 supplemental sessions. Each session included self-guided Web content, followed by a videoconference call with a therapist to discuss content and practice parenting skills with live feedback. Families in the control group received links to TBI Web resources.

Results: Parent income moderated treatment effects on parent functioning. Specifically, lower-income parents in the parenting skills group reported significant reductions in psychological distress compared with lower-income parents in the control group. No differences were found among higher-income parents for depression, parenting stress, or caregiver efficacy.

Conclusions: Parent training interventions post-TBI may be particularly valuable for lower-income parents who are vulnerable to both environmental and injury-related stresses.

Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Mss Raj, Antonini, and Oberjohn and Drs Cassedy, Makoroff, and Wade); Psychology Department, Miami University, Oxford, Ohio (Ms Raj); and Psychology Department, University of Cincinnati, Cincinnati, Ohio (Ms Antonini).

Corresponding Author: Shari L. Wade, PhD, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, ML 4009, Cincinnati, OH 45229 (

A portion of this work was presented at the 2011 annual meeting of the Society for Computers in Psychology in Seattle, Washington; the 2011 Federal Interagency Conference on Traumatic Brain Injury in Washington, District of Columbia; and the 2012 Butters-Kaplan West Coast Neuropsychology Conference.

This work was supported by the National Institute on Disability and Rehabilitation Research, Department of Education (grant nos. H133G060167 and H133B090010 to S.L.W.).

The authors declare that they have no conflicts of interest.

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