Formative Design and Evaluation of a Responsive eHealth/mHealth Intervention for Positive Family Adaptation Following Pe
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Formative Design and Evaluation of a Responsive eHealth/mHealth Intervention for Positive Family Adaptation Following Pediatric Traumatic Brain Injury Matthew Schmidt 1
&
Li Cheng 1 & Stacey Raj 2 & Shari Wade 3
# Association for Educational Communications & Technology 2020
Abstract This paper describes the formative design and evaluation of a self-guided online program called “Road to Recovery” to provide education, support, and skills training for parents and caregivers of children with traumatic brain injury (TBI) in the acute phase following injury. TBI is a leading cause of death and disability in childhood and can lead to substantial family stress and burden, particularly during the initial months post-injury. Road to Recovery directly addresses the need for resources to support families while adapting to this “new normal.” This online program was designed and developed using the Successive Approximation Model of instructional design. Formative evaluation was conducted across three phases of design, with improvements implemented following each phase. The result is a highly usable online program that is responsive to identified parent and caregiver needs. Keywords eHealth . Intervention . User experience design . Traumatic brain injury . Positive family adaptation
Pediatric traumatic brain injury (TBI) is a leading cause of acquired disability in childhood and can result in a range of short- and long-term challenges for children/adolescents and their families. These challenges include impairment in daily functioning, self-care, communication, learning, and social development, as well as externalizing behavior problems (e.g., Anderson et al. 2010; Chapman et al. 2010; Janusz et al. 2002; Lajiness-O'Neill et al. 2010. Emergent externalizing behavior problems are particularly common among children/adolescents who have sustained moderate to severe TBI (e.g., Bloom et al. 2001; Kennedy et al. 2017; Schwartz et al. 2003; Williams et al. 2015), and can contribute to negative life trajectories (Perron and Howard 2008). Important, though often overlooked, factors influencing child/adolescent outcomes following pediatric TBI are parenting behaviors and parent/caregiver psychological functioning (hereafter referred
* Matthew Schmidt [email protected] 1
University of Florida, Gainesville FL, USA
2
Xavier University, Cincinnati, OH, USA
3
Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
to as “parents”) or family functioning more broadly. Poor parent psychological functioning has been found to exacerbate child behavior problems following injury (e.g., Raj et al. 2013) and positive parenting may mitigate the adverse effects of TBI on child behavior (Treble-Barna et al. 2016). Moreover, the timing of positive parenting is critical to minimize the influence of TBI on child behavior (Treble-Barna et al. 2016). Given that parents of children who have sustained TBI are at risk of worsening psychological well-being (e.g., Aitken et al. 2009; Hawley et al. 2003; Wade et al. 1998) and that parent func
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