title: Pilot Randomized Controlled Trial of a Novel Web-Based Intervention to Prevent Posttraumatic Stress in Children Following Medical Events.
abstract: OBJECTIVE
  To assess feasibility and estimate effect size of a self-directed online intervention designed to prevent persistent posttraumatic stress after acute trauma.
  
  
  METHODS
  Children aged 8-12 years with a recent acute medical event were randomized to the intervention (N = 36) or a 12-week wait list (N = 36). Posttraumatic stress, health-related quality of life, appraisals, and coping were assessed at baseline, 6, 12, and 18 weeks.
  
  
  RESULTS
  Most children used the intervention; half completed it. Medium between-group effect sizes were observed for change in posttraumatic stress severity from baseline to 6 weeks (d = -.68) or 12 weeks (d = -.55). Exploratory analyses suggest greatest impact for at-risk children, and a small effect for intervention initiated after 12 weeks. Analysis of covariance did not indicate statistically significant group differences in 12-week outcomes.
  
  
  CONCLUSIONS
  This pilot randomized controlled trial provides preliminary evidence that a self-directed online preventive intervention is feasible to deliver, and could have an effect in preventing persistent posttraumatic stress.
authors.affiliation: Children's Hospital of Philadelphia, University of Pennsylvania, nlkaphd@mail.med.upenn.edu.
authors.forename: Nancy
authors.initials: N
authors.lastname: Kassam-Adams
authors.affiliation: Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Marsac
authors.affiliation: Children's Hospital of Philadelphia.
authors.forename: Kristen L
authors.initials: KL
authors.lastname: Kohser
authors.affiliation: University of Queensland, and.
authors.forename: Justin
authors.initials: J
authors.lastname: Kenardy
authors.affiliation: University of Southern Queensland.
authors.forename: Sonja
authors.initials: S
authors.lastname: March
authors.affiliation: Children's Hospital of Philadelphia, University of Pennsylvania.
authors.forename: Flaura K
authors.initials: FK
authors.lastname: Winston
mesh_terms: D000223:Adaptation, Psychological; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D010865:Pilot Projects; D011314:Preventive Health Services / Q000379:methods*; D011788:Quality of Life; D016037:Single-Blind Method; D013313:Stress Disorders, Post-Traumatic / Q000517:prevention & control*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000523:psychology*
keywords: adjustment; posttraumatic stress; randomized controlled trial