Pilot of a Text Messaging System to Monitor Caregivers’ and Children’s Mental Health Recovery After Pediatric Traumatic Injury

Objective: Pediatric traumatic injury (PTI) is associated with a high risk for psychiatric sequelae. Most trauma centers do not adequately address the emotional needs of children and their caregivers. Technology-based programs offer a low-cost and low-burden opportunity to track and potentially enhance families’ emotional recovery following PTI. This feasibility pilot project was designed to examine caregivers’ usage of and feedback on a text message-based symptom monitoring service. Method: Participants included 25 caregivers of PTI patients under age 12. Caregivers received up to four texts daily for 30 days postdischarge from the automated system: one symptom-based question to capture the current mental health status of the caregiver and child, respectively, and a corresponding educational tip each time a symptom was endorsed. Data analyses describe the number of questions to which caregivers responded on behalf of themselves and their children. A semistructured qualitative interview was used to assess caregivers’ reactions and suggested improvements for the service. Results: Almost all caregivers (91.1%) responded to at least one text message, and two thirds (66.6%) responded to over half of the messages. Themes from the qualitative interviews indicated that caregivers perceived the timing and content of the text messaging service facilitated their own and their child’s emotional recovery following PTI. Caregivers suggested that the service could be improved by providing an option to interact directly with mental health care providers. Conclusions: Text message-based symptom monitoring services offer an opportunity to bridge the gap in mental health services during the acute recovery phase for families of traumatically injured children.