Findings from a Randomized Controlled Trial of R2R-TBI: A Self-Guided Online Intervention to Promote Parent/Caregiver Wellbeing and Positive Parenting Following Pediatric Traumatic Brain Injury

While the early recovery period following pediatric traumatic brain injury (TBI) represents a critical window to scaffold recovery, it is a challenging time to engage families. We developed and trialed an online self-guided intervention designed to support parent/caregiver wellbeing and promote positive parenting in the initial months after moderate-to-severe TBI. The ten Road-To-Recovery-TBI (R2R-TBI) modules deliver psychoeducation, promote parent/caregiver stress management/self-care, teach positive parenting skills, and support family communication. We conducted a randomized controlled trial comparing R2R-TBI to an internet resource condition, with the aims of establishing efficacy, and examining usability and satisfaction with the R2R-TBI intervention. Ninety-four parents/caregivers consented and completed baseline measures within 3 months of their child being discharged from the hospital. Seventy-seven parents/caregivers provided follow-up data an average of 1.8 months after T1/baseline, and 71 provided data an average of 6 months after T1/baseline. This study was registered with clinicaltrials.gov (NCT05622461). Efficacy analyses found no additional benefit of R2R-TBI over the internet resources condition on caregiver psychological functioning, family functioning, or child quality of life at follow-ups. About one-third of parents/caregivers in each group failed to log on. Caregivers who actively engaged with the intervention reported good usability and satisfaction and considered the program to be helpful. Online education/skill-building programs like R2R-TBI may be valuable but insufficient for supporting psychosocial recovery for all families. Further research is needed to identify families who may/may not be poised to benefit from online interventions in the initial months following pediatric TBI.