Symposia
Trauma and Stressor Related Disorders and Disasters
Tatiana Davidson, Ph.D.
Associate Professor
Medical University of South Carolina
charleston, South Carolina
Kristen Higgins, M.A.
Research Assistant
Medical University of South Carolina
Mt. Pleasant, South Carolina
Olivia Bravoco, BS
Program Manager
Medical University of South Carolina
Charleston, South Carolina
Robert Gates, MD, FACS
Trauma Program Director
Prisma Health Upstate
Greenville, South Carolina
David Mooney, MD, MPH
Trauma Program Director
Boston Children's Hospital
Boston, Massachusetts
Robert Russell, MD, MPH
Trauma Program Director
Children's of Alabama Hospital
Birmingham, Alabama
Kenneth Ruggiero, PhD
Professor
Medical University of South Carolina
Charleston, SC
Pediatric traumatic injury is the leading cause of death and morbidity among US adolescents and are associated with mental health and health risk outcomes, including posttraumatic stress and depression, deficits in physical recovery, and quality of life. Current guidelines by the American College of Surgeons (ACS) Committee on Trauma strongly recommend screening and addressing emotional recovery in traumatic injury patients. In 2015 our team launched the Trauma Resilience and Recovery Program (TRRP), a scalable and sustainable, technology-enhanced, stepped model of care – one of the few in the US - that provides early intervention and direct services to improve access to evidence-based mental health care after traumatic injury. TRRP includes 3 major steps: (1) in-hospital education, screening, and tracking emotional recovery via an automated text-messaging system, (2) a 30-day screen to identify patients who are good candidates for psychological treatment, and (3) providing referral to best-practice treatment. TRRP has served over 4,500 adult and pediatric traumatic injury patients. We estimated based on TRRP patient engagement data, versus historical comparison data, that patient access to mental health follow-up increased at least ten-fold. In the last year, we approached 214 eligible adolescent (ages 12-17) patients, 98% of whom agreed to enroll. In-hospital, 78.3% of children and 68.5% of caregivers reported clinically significant levels of distress. Of the families enrolled, 36% reported clinically significant PTSD and/or depression. Nearly 76% of patients with significant symptomology agreed to assessment/treatment referrals. Through a recent award (1R01HD102336-01A1; PI: Davidson) we partnered with three accredited Level I and II pediatric trauma centers to conduct a multi-site hybrid 1 effectiveness-implementation trial with 300 adolescents to assess the extent to which TRRP promotes improvement in emotional recovery and gather data on the potential for TRRP to be implemented in other pediatric trauma centers. This paper will present data on program implementation as well as preliminary patient engagement and descriptive data from our partnering sites.