Results Summary

What was the research about?

Accidental injuries, such as serious burns or broken bones, are a major reason why children go to the hospital. After their bodies heal, children sometimes have social or emotional problems that remain. It can be hard for parents to know how to talk to their children to help them get better.

In this study, the research team compared two ways to help parents talk to their child after a serious injury:

  • The Link for Injured Kids program. Before leaving the hospital, parents watched a video and received training about talking with their children about their injury.
  • Trauma education. As they left the hospital, parents received a booklet with tips on talking with their children.

The team looked at children’s symptoms of posttraumatic stress disorder, or PTSD, and depression. They also looked at quality of life, emotional problems, and behaviors like how children act around their peers.

What were the results?

After six months, the two approaches didn’t differ in the children’s symptoms of PTSD and depression. In both approaches, children had fewer PTSD and depression symptoms.

Compared with children of parents who received trauma education, children of parents in the Link program had slightly fewer behavior problems. Quality of life was similar for both approaches.

Who was in the study?

The study included 314 parent-child pairs. Children were ages 10 to 17 and had been in the hospital because of an accident. Of the children, 86 percent were white, 4 percent were African American, 6 percent were another race or more than one race, and 3 percent didn’t report a race. Also, 8 percent were Hispanic. The average age was 14, and 63 percent were boys.

What did the research team do?

While parents were still at the hospital, the research team assigned parents by chance to either the Link program or trauma education. After six weeks, parents in the Link program received a follow-up training. Parents in the trauma education group got a new booklet if they needed one. Parents and children in both groups filled out surveys at the hospital and again at six weeks, three months, and six months later.

Patients, caregivers, doctors, and people working in community health gave input on the study.

What were the limits of the study?

This study took place in one state. Findings may differ in other places.

In future studies, researchers could look at other programs that help improve social and emotional problems for children with accidental injuries.

How can people use the results?

Hospitals and doctors can use these results when looking for ways to help parents talk to their child after an injury.

Final Research Report

View this project's final research report.

More About This Research

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • The reviewers said it was not clear whether either of the two interventions was more effective than no intervention. The researchers acknowledged the limited evidence for the efficacy of the interventions but noted that psychoeducation has been found to be more effective than no treatment in previous studies. The researchers added information about prior efficacy studies of psychoeducation and the Link for Injured Kids program to the background section of the report. They also noted that focus groups identified a need for more support for injured children and their parents, so doing nothing seemed insensitive since it was not guaranteed that children would recover naturally over time.
  • The reviewers asked about the exclusion of various categories of trauma patients, such as those with intellectual disabilities, mental illness, or patients who did not speak English. The researchers acknowledged the limited racial and ethnic diversity of study participants, commenting that the homogeneity of participants was unsurprising given the Midwestern sites of the study. The study criteria excluded children with severe mental illness and intellectual disabilities because they might have not been able to complete the self-administered questionnaires, and their responses may not have been reliable. Spanish-speaking families were not included because materials had not been translated and tailored for them.
  • The reviewers wondered if the sample size was adequate to test differences between rural and urban patients. The researchers said they did not meet their recruitment goals for the rural sample, and therefore, they did not have the statistical power to address all the questions they planned.
  • The reviewers commented that the participation rate in the study was low and that the loss to follow-up was substantial. The researchers argued that the participation rate was reasonable based on the number of eligible subjects, and the rate of loss to follow-up was within the expected range for a trauma study.

Conflict of Interest Disclosures

View the COI disclosure form.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers commented, and the researchers made changes or provided responses. The comments and responses included the following:

  • The reviewers said it was not clear whether either of the two interventions was more effective than no intervention. The researchers acknowledged the limited evidence for the efficacy of the interventions but noted that psychoeducation has been found to be more effective than no treatment in previous studies. The researchers added information about prior efficacy studies of psychoeducation and the Link for Injured Kids program to the background section of the report. They also noted that focus groups identified a need for more support for injured children and their parents, so doing nothing seemed insensitive since it was not guaranteed that children would recover naturally over time.
  • The reviewers asked about the exclusion of various categories of trauma patients, such as those with intellectual disabilities, mental illness, or patients who did not speak English. The researchers acknowledged the limited racial and ethnic diversity of study participants, commenting that the homogeneity of participants was unsurprising given the Midwestern sites of the study. The study criteria excluded children with severe mental illness and intellectual disabilities because they might have not been able to complete the self-administered questionnaires, and their responses may not have been reliable. Spanish-speaking families were not included because materials had not been translated and tailored for them.
  • The reviewers wondered if the sample size was adequate to test differences between rural and urban patients. The researchers said they did not meet their recruitment goals for the rural sample, and therefore, they did not have the statistical power to address all the questions they planned.
  • The reviewers commented that the participation rate in the study was low and that the loss to follow-up was substantial. The researchers argued that the participation rate was reasonable based on the number of eligible subjects, and the rate of loss to follow-up was within the expected range for a trauma study.

Conflict of Interest Disclosures

Project Information

Marizen Ramirez, MPH, PhD
University of Iowa
$1,788,712
10.25302/07.2020.CER.130602918

Key Dates

54 months
December 2013
October 2019
2013
2019

Study Registration Information

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Last updated: October 20, 2021