Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial

Kenneth J. Ruggiero, Matthew Price, Zachary Adams, Kirstin Stauffacher, Jenna McCauley, Carla Kmett Danielson, Rebecca Knapp, Rochelle F. Hanson, Tatiana M. Davidson, Ananda B. Amstadter, Matthew J. Carpenter, Benjamin E. Saunders, Dean G. Kilpatrick, Heidi S. Resnick

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. Method: 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). Conclusion: 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. Clinical trial registration information: Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.

Original languageEnglish (US)
Pages (from-to)709-717
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume54
Issue number9
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Disasters
Randomized Controlled Trials
Post-Traumatic Stress Disorders
Mental Health
Depression
Population
Parents
Tornadoes
Health Status
Clinical Trials
Interviews
Technology

Keywords

  • depression
  • disaster mental health
  • posttraumatic stress
  • technology

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

Web Intervention for Adolescents Affected by Disaster : Population-Based Randomized Controlled Trial. / Ruggiero, Kenneth J.; Price, Matthew; Adams, Zachary; Stauffacher, Kirstin; McCauley, Jenna; Danielson, Carla Kmett; Knapp, Rebecca; Hanson, Rochelle F.; Davidson, Tatiana M.; Amstadter, Ananda B.; Carpenter, Matthew J.; Saunders, Benjamin E.; Kilpatrick, Dean G.; Resnick, Heidi S.

In: Journal of the American Academy of Child and Adolescent Psychiatry, Vol. 54, No. 9, 01.09.2015, p. 709-717.

Research output: Contribution to journalArticle

Ruggiero, KJ, Price, M, Adams, Z, Stauffacher, K, McCauley, J, Danielson, CK, Knapp, R, Hanson, RF, Davidson, TM, Amstadter, AB, Carpenter, MJ, Saunders, BE, Kilpatrick, DG & Resnick, HS 2015, 'Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial', Journal of the American Academy of Child and Adolescent Psychiatry, vol. 54, no. 9, pp. 709-717. https://doi.org/10.1016/j.jaac.2015.07.001
Ruggiero, Kenneth J. ; Price, Matthew ; Adams, Zachary ; Stauffacher, Kirstin ; McCauley, Jenna ; Danielson, Carla Kmett ; Knapp, Rebecca ; Hanson, Rochelle F. ; Davidson, Tatiana M. ; Amstadter, Ananda B. ; Carpenter, Matthew J. ; Saunders, Benjamin E. ; Kilpatrick, Dean G. ; Resnick, Heidi S. / Web Intervention for Adolescents Affected by Disaster : Population-Based Randomized Controlled Trial. In: Journal of the American Academy of Child and Adolescent Psychiatry. 2015 ; Vol. 54, No. 9. pp. 709-717.
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N2 - Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. Method: 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). Conclusion: 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. Clinical trial registration information: Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.

AB - Objective: To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. Method: 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). Conclusion: 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. Clinical trial registration information: Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.

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