PROJECT SUMMARY/ABSTRACT
Pediatric traumatic injury (PTI) is a public health priority, with nearly 300,000 children incurring injuries so
severe that they require hospitalization each year. PTI is associated with annual individual and societal costs of
$87 billion and elevates risk for posttraumatic stress, depression, and other health risk consequences that
affect quality of life, physical recovery, emotional and behavioral outcomes, family roles and routines, and
academic functioning. Follow-up care for affected children and caregivers is critical to support behavioral and
emotional recovery, but few trauma centers provide these services and established, scalable models of care
are lacking. Cost-effective, sustainable interventions are needed to reduce barriers to care and reach families
that need it most. Pilot data collected by the candidate suggest that a technology-enhanced model of care is
appealing to caregivers and has high potential to address service barriers by providing real-time assistance to
help caregivers manage their own distress and their children’s behavioral and emotional recovery. The
candidate proposes to develop and systematically evaluate CAARE (Caregivers’ Aid to Accelerate Recovery
after pediatric Emergencies), an intervention informed by our ongoing clinical initiatives together with results of
qualitative semi-structured interviews with caregivers of young children after PTI. CAARE will consist of
education, self-monitoring, and coping resources. Specific aims include: 1) finalize the CAARE model and
research protocol with ~15 caregivers after PTI; 2) pilot test CAARE via an open trial (n=60); and 3) assess
CAARE implementation feasibility with families (n~20), trauma center directors (n~15), and program managers
(n~15). The research environment, facilities, and resources at MUSC are ideally suited for mentored career
development in child traumatic stress research. Dovetailing with the research aims, K23 training objectives are
to: 1) develop proficiency in clinical trial design, implementation, and evaluation; 2) enhance proficiency in the
use of iterative-design technology-based solutions; 3) develop expertise in implementation science; 4) enhance
statistical training in clinical trials, longitudinal analyses, and qualitative data analysis; and 5) expand skills in
scientific communication, including grant writing, presentations, and publications. Mentorship and consultation
from experts in pediatric trauma, health technology solutions, implementation science, and advanced statistics
will ensure training goals are met. The candidate’s long-term career goal is to establish a research portfolio
that develops, rigorously tests, and scales innovative, cost-efficient, evidence-based health technology
resources to improve access and quality of care for trauma-impacted families in real-world settings. These
research and training goals directly correspond with priorities detailed in NICHD’s Pediatric Trauma and Critical
Illness Branch, and will allow the candidate to become an internationally recognized leader in child and family
trauma prevention and treatment research. The training proposed herein is designed to develop expertise in
this area, represents a clear progression from prior training, and would not be possible without this K23.
