title: Systematic, theoretically-grounded development and feasibility testing of an innovative, preventive web-based game for children exposed to acute trauma.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To describe evidence and the program theory model applied to the Coping Coach intervention and present pilot data evaluating intervention feasibility and acceptability.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia Department of Psychiatry, University of Pennsylvania.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Marsac
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Flaura K
authors.initials: FK
authors.lastname: Winston
authors.affiliation: Department of Psychology, Drexel University The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia.
authors.forename: Aimee K
authors.initials: AK
authors.lastname: Hildenbrand
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Kohser
authors.affiliation: School of Psychology, Counselling and Community, University of Southern Queensland.
authors.forename: Sonja
authors.initials: S
authors.lastname: March
authors.affiliation: School of Psychology, University of Queensland.
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
authors.affiliation: The Center for Injury Research and Prevention, The Children's Hospital of Philadelphia Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kassam-Adams
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