Hybrid type 1 randomized controlled trial of technology-assisted stepped care behavioral health intervention for caregivers and children following pediatric traumatic injury

Authors

• Leigh E. Ridings, Medical University of South CarolinaFollow
• Kari N. Thomsen, Medical University of South Carolina
• Margaret A. Prentice, Medical University of South Carolina
• Ebonie Powell, Medical University of South Carolina
• Gabriela Becerra, Medical University of South Carolina
• Martina Mueller, Medical University of South Carolina
• Rochelle Hanson, Medical University of South Carolina
• Christian J. Streck, Medical University of South Carolina
• Peter Ehrlich, C.S. Mott Children’s Hospital
• Linda Ewing-Cobbs, University of Texas Medical School at Houston
• Meghan L. Marsac, University of KentuckyFollow
• Ryan Spurrier, University of Southern California
• Tatiana Davidson, Medical University of South Carolina
• Kenneth J. Ruggiero, Medical University of South Carolina

Abstract

Pediatric traumatic injury (PTI) has substantial physical and emotional health impacts, sometimes resulting in hospitalization and/or the development of posttraumatic stress disorder (PTSD) and depression in children. Caregivers are a key source of support for children following PTI; however, many caregivers experience their own distress and psychological reactions following injury. The CAARE (Caregivers' Aid to Accelerate Recovery after pediatric Emergencies) model is a technology-assisted, stepped care intervention to support the emotional and behavioral recovery of preadolescent children hospitalized after PTI and their caregivers. The CAARE model seeks to provide a systematic, evidence-based screening and intervention procedure that is feasible to implement within pediatric trauma centers. This protocol paper describes a study to evaluate the effectiveness of the CAARE model in improving quality of life, clinical and functional outcomes, and treatment engagement in children and their caregivers following PTI. We also aim to explore potential inequities regarding race, ethnicity, and injury type. This hybrid type 1 effectiveness-implementation trial design allows for the examination of contextual factors related to implementation of CAARE. This paper includes a description of the intervention and control conditions, participant selection and recruitment procedures, assessment measures, and planned quantitative and qualitative methodologies. Potential implications and future directions are discussed.This study was registered in ClinicalTrials.gov (NCT04579198).

Document Type

Article

Publication Date

7-1-2026

Notes/Citation Information

Publisher Copyright: © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

Digital Object Identifier (DOI)

10.1016/j.cct.2026.108352

Archival?

Archival

Repository Citation

Ridings, Leigh E.; Thomsen, Kari N.; Prentice, Margaret A.; Powell, Ebonie; Becerra, Gabriela; Mueller, Martina; Hanson, Rochelle; Streck, Christian J.; Ehrlich, Peter; Ewing-Cobbs, Linda; Marsac, Meghan L.; Spurrier, Ryan; Davidson, Tatiana; and Ruggiero, Kenneth J., "Hybrid type 1 randomized controlled trial of technology-assisted stepped care behavioral health intervention for caregivers and children following pediatric traumatic injury" (2026). Psychiatry Faculty Publications. 60.
https://uknowledge.uky.edu/psychiatry_facpub/60