{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T07:33:22Z","timestamp":1793691202679,"version":"4.5.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T00:00:00Z","timestamp":1671840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R21HD087844"],"award-info":[{"award-number":["R21HD087844"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,20]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to examine the efficacy of the SMART (Self-Management After Recent Traumatic brain injury) program and potential moderators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Parallel randomized controlled trial (ClinicalTrials.gov Identifier: NCT03498495) was conducted. Eligibility criteria included treatment for mild traumatic brain injury in the emergency department and age 11\u201318 years. Participants were assigned equally to SMART (n\u2009=\u200935) or usual care (UC; n\u2009=\u200936). SMART included symptom monitoring and online modules supporting the return to activities and symptom management. Coping and quality of life (QoL) (primary outcomes) and post-concussive symptoms (secondary outcome) were assessed at baseline and weekly for 4 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Groups did not differ in coping, QoL, or return to pre-injury symptom levels at any time point. Problem-focused engagement (PFE) moderated group differences over time (p\u2009=\u2009.02). At high PFE, UC participants reported lower QoL at time 1 (effect size [ES]\u2009=\u20090.60); SMART participants did not report a decline at any point. At low PFE, SMART participants reported declining QoL from pre-injury to time 1 (ES\u2009=\u20090.68), whereas UC participants reported an increase from time 1 to 3 (ES\u2009=\u20090.56). PFE also moderated group differences on the Health and Behavior Inventory (HBI) cognitive (p\u2009=\u2009.02) and somatic symptom scales (p\u2009=\u2009.05). At high PFE, SMART participants reported a more rapid return to pre-injury levels than UC participants (p\u2009=\u2009.05). Resilience also moderated group differences in QoL and HBI cognitive recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Effectiveness of the SMART app varied based on preinjury coping styles and resilience, underscoring the potential need to tailor treatments to individual characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jpepsy\/jsac086","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T18:41:31Z","timestamp":1671907291000},"page":"241-253","source":"Crossref","is-referenced-by-count":11,"title":["Findings from a Randomized Controlled Trial of SMART: An EHealth Intervention for Mild Traumatic Brain Injury"],"prefix":"10.1093","volume":"48","author":[{"given":"Shari L","family":"Wade","sequence":"first","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center , USA"},{"name":"University of Cincinnati , 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