title: Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial.
abstract: OBJECTIVE
  To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents.
  
  
  METHODS
  A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression.
  
  
  RESULTS
  Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p < .01) and depressive symptoms (B = -0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p = .06; depressive symptoms: B = -0.42, SE = 0.19, p = 0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33).
  
  
  CONCLUSIONS
  Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters.
  
  
  BACKGROUND
  Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.
authors: Medical University of South Carolina (MUSC) and the Ralph H. Johnson VA Medical Center, Charleston, SC. Electronic address: ruggierk@musc.edu.
authors: Kenneth J
authors: KJ
authors: Ruggiero
authors: University of Vermont, Burlington.
authors: Matthew
authors: M
authors: Price
authors: MUSC.
authors: Zachary
authors: Z
authors: Adams
authors: Ralph H. Johnson VA Medical Center, Charleston, SC.
authors: Kirstin
authors: K
authors: Stauffacher
authors: MUSC.
authors: Jenna
authors: J
authors: McCauley
authors: MUSC.
authors: Carla Kmett
authors: CK
authors: Danielson
authors: MUSC.
authors: Rebecca
authors: R
authors: Knapp
authors: MUSC.
authors: Rochelle F
authors: RF
authors: Hanson
authors: Medical University of South Carolina (MUSC) and the Ralph H. Johnson VA Medical Center, Charleston, SC.
authors: Tatiana M
authors: TM
authors: Davidson
authors: Virginia Commonwealth University, Richmond.
authors: Ananda B
authors: AB
authors: Amstadter
authors: MUSC.
authors: Matthew J
authors: MJ
authors: Carpenter
authors: MUSC.
authors: Benjamin E
authors: BE
authors: Saunders
authors: MUSC.
authors: Dean G
authors: DG
authors: Kilpatrick
authors: MUSC.
authors: Heidi S
authors: HS
authors: Resnick
mesh_terms: D000293:Adolescent; D000407:Alabama; D000437:Alcoholism / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000175:diagnosis / Q000628:therapy*; D064891:Disaster Victims / Q000523:psychology*; D004190:Disasters; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health; D008923:Missouri; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000628:therapy*; D055869:Tornadoes
keywords: depression; disaster mental health; posttraumatic stress; technology