Web-Based Parenting Skills Program for Pediatric Traumatic Brain Injury Reduces Psychological Distress Among Lower-Income Parents.
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).
Stacey P
SP
Raj
Tanya N
TN
Antonini
Karen S
KS
Oberjohn
Amy
A
Cassedy
Kathi L
KL
Makoroff
Shari L
SL
Wade
D001007:Anxiety / Q000517:prevention & control; D001930:Brain Injuries / Q000175:diagnosis / Q000534:rehabilitation*; D017028:Caregivers / Q000193:education* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000517:prevention & control; D004505:Education, Nonprofessional / Q000458:organization & administration*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000193:education; D011203:Poverty; D015397:Program Evaluation; D012016:Reference Values; D020377:Self Efficacy; D013315:Stress, Psychological / Q000517:prevention & control; D016896:Treatment Outcome; D049269:Videoconferencing