Systematic, theoretically grounded development and feasibility testing of an innovative, preventive web-based game for children exposed to acute trauma

Millions of children are affected by acute medical events annually, creating a need for resources to promote recovery. Although web-based interventions promise wide reach and low cost for users, development can be time- and cost-intensive. A systematic approach to intervention development can help to minimize costs and increase the likelihood of effectiveness. Using a systematic approach, our team integrated evidence on the etiology of traumatic stress, an explicit program theory, and a user-centered design process to intervention development. This study describes evidence and the program theory model applied to the Coping Coach intervention and presents pilot data evaluating intervention feasibility and acceptability. Informed by empirical evidence on traumatic stress prevention, an overarching program theory model was articulated to delineate pathways from specific intervention content to program targets and proximal outcomes to key longer-term health outcomes. Systematic user-testing with children ages 8-12 years (N = 42) exposed to an acute medical event and their parents was conducted throughout intervention development. Functionality challenges in early prototypes necessitated revisions. Child engagement was positive throughout revisions to the Coping Coach intervention. Final pilot-testing demonstrated promising feasibility and high user-engagement and satisfaction. In conclusion, applying a systematic approach to the development of Coping Coach led to the creation of a functional intervention that is accepted by children and parents. Development of new e-health interventions may benefit from a similar approach. Future research should evaluate the efficacy of Coping Coach in achieving targeted outcomes of reduced trauma symptoms and improved health-related quality of life.