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Trauma and Stressor Related Disorders and Disasters

Technology Use, Demographic, and Injury Characteristics Associated with the Ability to Engage and Follow-Up with Traumatic Injury Survivors at Risk for Developing PTSD: A 25 Site US National Study

(PS11-A25) Technology Use, Demographic, and Injury Characteristics Associated with the Ability to Engage and Follow-up with Traumatic Injury Survivors at Risk for Developing PTSD: A 25 Site US National Study

Saturday, November 18, 2023
2:30 PM – 3:30 PM PST
Location: Regency Ballroom, Level 7
Early cognitive behavioral intervention delivery for patients at risk for Posttraumatic Stress Disorder (PTSD) relies upon the ability to engage and follow trauma exposed patients. Recent requirements by the American College of Surgeons on Trauma (College) have mandated screening and referral for patients with high levels of psychological distress, at risk for the development of PTSD. Investigations that assess factors associated with the ability to engage and follow injured trauma survivors may be essential in broadening the reach of College requirements to include cognitive behavioral intervention delivery. This investigation was a secondary analysis of data collected as part of a 25 level I trauma center site randomized clinical trial. All 635 patients included in the investigation were ages 18 or older and had high PTSD symptom levels (i.e. DSM-IV PTSD checklist score ≥ 35) at the time of the baseline trauma center admission. Baseline technology use, demographic and injury characteristics were collected for patients who were followed-up over the course of the year after injury. Logistic regression analyses were used to assess the associations between technology use, demographic and injury characteristics and the attainment of follow-up outcome assessments. Thirty-one percent of participants were missing one or more 3-, 6- or 12-month follow-up outcome assessment. Intentional injury (Odds Ratio (OR) = 1.48, 95% Confidence Interval (CI) = 1.02, 2.14) and public or no insurance status (OR = 1.71, 95% CI = 1.13, 2.58) were independently associated with increased odds of missing one or more follow-up assessments. Older age (ages >55 relative to 18–30 years of age, OR = 0.26, 95% CI 0.13, 0.51; age 31–55 relative to 18–30, OR = 0.57, 95% CI = 0.39, 0.84), having a cell phone (OR = 0.59, 95% CI = 0.35, 0.99) and having internet access (OR = 0.57, 95% CI = 0.33, 1.01) were independently associated with an increased odds of obtaining one or more follow-up assessment. Intervention and control group status was not significantly associated with attainment of follow up assessments. This multisite investigation suggests that younger, publicly insured and/or uninsured, intentionally injured patients, with barriers to cell phone and internet access may be particularly vulnerable to lapses in trauma center follow-up. Behavioral intervention development could productively incorporate strategies for patients at-risk for not engaging and adhering to follow-up. Behavioral interventions that serve to engage difficult-to-reach trauma-exposed populations may have the potential to be included in future College regulatory requirements.