SBIR-STTR Award

Traumatic brain injury (TBI) is reported to be the leading cause of death and disability for children aged 1 to 19 in the United States. Each year in the United States, approximately 30,000 children and youth experience significant disability from TBI as a result of collisions (i.e., automobile, motorcycle, and bicycle), falls, recreational injuries, and firearm incidents. TBI often results in significant and permanent alterations in social, behavioral, physical, and cognitive functioning. Understanding these changes and developing skills for managing the challenges associated with them are essential for long-term positive outcomes for survivors of TBI and their families. The goal of this project is to create a comprehensive educational and training resource for families and caregivers of children with TBI, emphasizing effective strategies for managing the three most common TBI challenges: cognitive, behavioral, and social disabilities. The Phase I project will focus on understanding cognitive changes and on environmental, compensatory, and communication strategies that can mitigate the impact of these changes on daily life. The efficacy of the Phase I prototype program will be evaluated in a within subject pretest-to-posttest study (N=40). Phase II development will expand content to include: (a) educational units on mechanisms of injury and the physical impact on the brain, (b) the effects of TBI on physical, behavioral and psychosocial functioning, (c) strategies for addressing behavioral and psychosocial challenges, and (d) a repeat-visit function. The completed Phase II program will be evaluated in a large-scale randomized trial.

Public Health Relevance:
Traumatic brain injury is a leading cause of death and disability in children aged 1-19 in the United States. Each injury is unique, and many result in thinking, learning, emotional, and behavioral complications. Families are ill-equipped to handle these changes. This program offers training regarding the cognitive, behavioral, and social challenges of childhood TBI with the web-based convenience of allowing "anytime/anywhere" learning.

Thesaurus Terms:
0-11 Years Old;Acquired Brain Injury;Address;Affect;Americas;Attorneys;Automobiles;Behavioral;Bicycling;Brain;Brain Injuries;Caring;Cause Of Death;Characteristics;Child;Child Youth;Childhood;Children (0-21);Cognitive;Cognitive Disturbance;Cognitive Impairment;Cognitive Decline;Cognitive Function Abnormal;Collaborations;Communication;Decision Trees;Development;Devices;Disturbance In Cognition;Educational Materials;Educational Process Of Instructing;Elements;Emotional;Encephalon;Encephalons;Evaluation;Family;Family Care Giver;Family Caregiver;Family Relations;Family Relationship;Family Member;Firearms;Foundations;Goals;Home;Home Environment;Human, Child;Impaired Cognition;Incentives;Individual;Information Resources;Injury;Insurance Carriers;Insurers;Internet;Interview;Knowledge;Knowledge Acquisition;Lawyers;Learning;Libraries;Life;Literature;Measures;Medical;Medical Care Costs;Methods And Techniques;Methods, Other;Modeling;Motorcycles;Multimedia;Multimedium;Nervous System, Brain;On-Line Systems;Online Systems;Outcome;Prov;Parents;Phase;Physical Health Services / Rehabilitation;Problem Solving;Process;Programs (Pt);Programs [publication Type];Provider;Rehabilitation;Rehabilitation Therapy;Rehabilitation, Medical;Reporting;Research;Research Resources;Resources;Sales;Services;Social Service;Social Work;Social Work (Field);Study Subject;Survey Instrument;Surveys;Survivors;Teaching;Techniques;Testing;Thinking;Thinking, Function;Training;Training Programs;Trauma, Brain;Traumatic Brain Injury;Traumatic Encephalopathy;United States;Visit;Www;Advocacy Organizations;Aged;Base;Brain Damage;Brain Injury;Brain Lesion (From Injury);Children;Cognitive Change;Cognitive Dysfunction;Cognitive Function;Cognitive Loss;Cognitively Impaired;Commercial Application;Commercialization;Community Setting;Design;Designing;Disability;Evaluation /Testing;Evaluation/Testing;Evidence Base;Experience;Falls;Improved;Incentive;Inducement;Interactive Multimedia;Knowledge Resource;Library;Life Time Cost;Lifetime Cost;Model;Model Design;Online Computer;Pediatric;Programs;Prototype;Psychosocial;Randomized Trial;Rehabilitative;Skill Acquisition;Skills;Social;Technological Innovation;Tool;Traumatic Brain Damage;Usability;Web;Web Based;World Wide Web;Youngster

Traumatic brain injury (TBI) is a leading cause of death and disability for children aged 1-19 in the United States. More than 60,000 children and adolescents are hospitalized annually in the U.S. after sustaining moderate-severe brain injuries from motor vehicle crashes, falls, sports, and physical abuse; more than 600,000 are seen in hospital emergency rooms and released. TBI often results in significant and permanent alterations in social, behavioral, physical, and cognitive functioning. Understanding these changes and developing skills to manage the challenges associated with them are essential for long-term positive outcomes for children with TBI and their families. The goal of this project is o produce the Traumatic Brain Injury Positive Strategies (TIPS) program, a comprehensive educational and training resource to help families improve their knowledge and skills in supporting a child with TBI experiencing cognitive, behavioral, and social challenges. The online product will include: (a) the TBI Resource Center, an extensive library of educational materials, information, and resources about childhood TBI, and (b) the Training Center, which will provide training in a range of evidence-based strategies within a problem-solving framework. Phase I of this project produced and evaluated prototype content, for the Training Center, including two Supporting Cognition modules and a Problem-Solving Basics module. The prototype was evaluated with 47 parents of children ages 5-18 with TBI. Significant results from the within-subject evaluation demonstrated gains in parents' self-efficacy, general TBI knowledge, and knowledge application. In Phase II, we will develop (a) an assessment module to identify key areas of parent concern, (b) additional training modules addressing cognitive, behavioral, and social domains, (c) the TBI Resource Center, and (d) functionality for hospital website integration. To promote knowledge and skill acquisition, the program will integrate evidence-based instructional design elements with video-based modeling, taking full advantage of the web's interactive capabilities. The program will be developed using an iterative process with an advisory board of rehabilitation professionals from three collaborating children's hospitals. We will determine the efficacy of the TIPS program in a randomized controlled trial with 216 parents of children with TBI. Program feasibility will be demonstrated by the achievement of significant program effects, a high level of program usage, and a high degree of user satisfaction.

Public Health Relevance Statement:


Public Health Relevance:
The Traumatic Brain Injury Positive Strategies (TIPS) program is a comprehensive educational and training resource to help families improve their knowledge and skills in supporting a child with TBI experiencing cognitive, behavioral, and social challenges. The program provides training in evidence-based support strategies with the goal of improving outcomes for children with TBI and their families.

NIH Spending Category:
Basic Behavioral and Social Science; Behavioral and Social Science; Brain Disorders; Clinical Research; Health Services; Injury (total) Accidents/Adverse Effects; Injury - Childhood Injuries; Injury - Trauma - (Head and Spine); Injury - Traumatic brain injury; Injury - Unintentional Childhood Injury; Neurosciences; Pediatric; Rehabilitation

Project Terms:
Accident and Emergency department; Achievement; Address; Affect; Age; aged; Architecture; Area; base; Behavior; behavior change; Behavior Control; Behavioral; Brain Injuries; Caring; Cause of Death; Characteristics; Child; Child Rearing; Childhood; Cognition; Cognitive; cognitive change; cognitive function; commercialization; computer program; cost; design; Development; disability; Educational Materials; Elements; Evaluation; evidence base; experience; falls; Family; Focus Groups; Goals; Group Interviews; Health; Hospitalized Adolescent; Hospitals; improved; improved outcome; Incentives; Information Resources; Insurance Carriers; interest; Internet; Interview; Knowledge; Knowledge acquisition; Libraries; Life; Literature; Measures; Mediating; Medical Care Costs; model design; Modeling; Modification; Narration; Notification; Online Systems; Outcome; Parents; Pediatric Hospitals; pediatric traumatic brain injury; Phase; physical abuse; Planning Theory; Positioning Attribute; Problem Solving; Process; programs; prototype; Provider; public health relevance; Randomized Controlled Trials; Rehabilitation therapy; Research; Resources; satisfaction; screening; Self Efficacy; Services; skill acquisition; skills; social; social skills; Social support; Social Work; Sports; Testing; theories; TimeLine; tool; Training; Training Activity; Traumatic Brain Injury; United States; Vehicle crash; web site; Work