PilotBrain injury2024

Improving post-concussion discharge education for families seeking emergency department care: intervention development.

Emily Kroshus, Mary Kathleen Steiner, Sara P D Chrisman and 5 others

PMID 38441083

WHAT IT FOUND

Parents found a post-discharge text messaging program acceptable.

While it did not change knowledge or general self-efficacy, parents who received the texts reported significantly more emotionally supportive communication with their recovering child than those who did not.

Key findings

01Parents rated the acceptability of the text-messaging intervention at 4.20 on a 5-point scale, exceeding the pre-set threshold for acceptability.

02Parents in the intervention group had significantly higher scores for emotionally supportive communication behaviors (6.71 vs 5.49) compared to controls.

03There were no statistically significant differences between groups in instrumental support behaviors, knowledge, or self-efficacy regarding emotional and instrumental support.

STILL TO COME

How it was doneWhat they found

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What it does not show

The pilot was not powered to detect differences in intervention effects between conditions; it was designed to assess feasibility and acceptability. The sample was drawn from a single urban pediatric emergency department, limiting generalizability. Participants were largely white, highly educated, and predominantly female, which may not reflect the broader population. The measures for parenting behaviors had low internal consistency (Cronbach’s alpha 0.55-0.59), and their validity is uncertain. The study did not assess the impact of the intervention on child outcomes or long-term recovery.

Declared interests

No conflicts of interest were reported. The study was supported by the National Institutes of Health (Extramural).

The easy way to misread this

Do not interpret the significant finding on emotionally supportive communication as proof of efficacy. The study was a small pilot not powered to detect clinical effects, and the low reliability of the behavior measures means this result may be unstable.

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The study

Participants
98 parents (15 parents and 15 clinicians in Step 1; 98 parents in Step 4 pilot)
Certainty of evidence
Very low

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    Emily Kroshus, Mary Kathleen Steiner, Sara P D Chrisman, et al. Improving post-concussion discharge education for families seeking emergency department care: intervention development. Brain injury. 2024.

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