Marsac Meghan L, Winston Flaura K, Hildenbrand Aimee K, Kohser Kristen L, March Sonja, Kenardy Justin, Kassam-Adams Nancy
The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia Department of Psychiatry, University of Pennsylvania.
The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania.
Clin Pract Pediatr Psychol. 2015;3(1):12-24. doi: 10.1037/cpp0000080.
Millions of children are affected by acute medical events annually, creating need for resources to promote recovery. While web-based interventions promise wide reach and low cost for users, development can be time- and cost-intensive. A systematic approach to intervention development can help to minimize costs and increase likelihood of effectiveness. Using a systematic approach, our team integrated evidence on the etiology of traumatic stress, an explicit program theory, and a user-centered design process to intervention development.
To describe evidence and the program theory model applied to the Coping Coach intervention and present pilot data evaluating intervention feasibility and acceptability.
Informed by empirical evidence on traumatic stress prevention, an overarching program theory model was articulated to delineate pathways from a) specific intervention content to b) program targets and proximal outcomes to c) key longer-term health outcomes. Systematic user-testing with children ages 8-12 (N = 42) exposed to an acute medical event and their parents was conducted throughout intervention development.
Functionality challenges in early prototypes necessitated revisions. Child engagement was positive throughout revisions to the Coping Coach intervention. Final pilot-testing demonstrated promising feasibility and high user-engagement and satisfaction.
Applying a systematic approach to the development of Coping Coach led to the creation of a functional intervention that is accepted by children and parents. Development of new e-health interventions may benefit from a similar approach. Future research should evaluate the efficacy of Coping Coach in achieving targeted outcomes of reduced trauma symptoms and improved health-related quality of life.
每年有数百万儿童受到急性医疗事件的影响，这就需要资源来促进康复。虽然基于网络的干预措施有望为用户提供广泛的覆盖范围和低成本，但开发过程可能既耗时又成本高昂。采用系统的干预开发方法有助于降低成本并提高有效性的可能性。我们的团队采用系统方法，将创伤应激病因学的证据、明确的项目理论和以用户为中心的设计过程整合到干预开发中。
描述应用于应对教练干预措施的证据和项目理论模型，并展示评估干预可行性和可接受性的试点数据。
根据创伤应激预防的实证证据，构建了一个总体项目理论模型，以描绘从a）特定干预内容到b）项目目标和近端结果，再到c）关键长期健康结果的路径。在整个干预开发过程中，对8至12岁经历过急性医疗事件的儿童（N = 42）及其父母进行了系统的用户测试。
早期原型中的功能挑战需要进行修订。在应对教练干预措施的整个修订过程中，儿童的参与度一直很高。最终的试点测试显示出有希望的可行性、高用户参与度和满意度。
采用系统方法开发应对教练干预措施，产生了一种儿童和家长都能接受的功能性干预措施。新的电子健康干预措施的开发可能会从类似方法中受益。未来的研究应评估应对教练在实现减少创伤症状和改善与健康相关生活质量等目标结果方面的疗效。
