{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:57:56Z","timestamp":1755226676792,"version":"3.43.0"},"reference-count":35,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Injury Insurance Scheme Queensland"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,23]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>For adolescents with brain injury, challenges with social function often persist into adulthood, impacting social participation and quality of life. The Programme for the Education and Enrichment of Relational Skills (PEERS) is a manualised group-based intervention with preliminary evidence demonstrating improved social knowledge and participation for adolescents with acquired brain injury or cerebral palsy when delivered face to face. The recent COVID-19 pandemic and challenges for families living outside metropolitan centres to access the programme suggest a telehealth delivered PEERS should be explored. This study aims to compare telehealth PEERS to usual care in a mixed-methods randomised waitlist-controlled trial to determine preliminary efficacy to improve social functioning and secondarily to determine acceptability, feasibility, cost and contextual factors impacting the implementation.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods and analysis<\/jats:title>\n<jats:p>In this single-centre mixed-methods randomised waitlist-controlled trial, 32 adolescents with brain injury, aged 11\u201317 years attending mainstream high school and their caregivers will be randomised to receive either (a) telehealth PEERS once\/week for 1.5\u2009hours for 14 weeks or (b) usual care (UC). UC is highly variable in Australia but often comprises fortnightly occupational therapy, physiotherapy or speech therapy. The waitlist group will then receive PEERS following the 26-week retention time point. Measures will be administered at baseline, 14 weeks (immediately post) and then 26 and 52 weeks post baseline. The primary outcome is self-reported performance and satisfaction with social goals on the Canadian Occupational Performance Measure at 14 weeks. Secondary outcomes include self and parent-reported social competence, frequency of get-togethers with peers, self-report knowledge of social skills, frequency of peer victimisation and quality of life. An implementation evaluation will be done to determine acceptability, feasibility, cost and identify barriers and facilitators in the implementation of the intervention and map these against the Consolidated Framework for Implementation Research. This study will assess the unit costs of implementing the PEERS from an Australian health system perspective.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Ethics and dissemination<\/jats:title>\n<jats:p>The Children\u2019s Health Queensland Hospital and Health Service and The University of Queensland Human Research Ethics Committees have approved this study. Findings will be disseminated in peer-reviewed journals and conference presentations.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Trial registration number<\/jats:title>\n<jats:p>ACTRN1263000082606.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081843","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T05:55:14Z","timestamp":1740549314000},"page":"e081843","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Telehealth Programme for the Education and Enrichment of Relational Skills (PEERS) for adolescents with acquired and congenital brain injuries: a protocol for mixed-methods randomised trial"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5395-544X","authenticated-orcid":false,"given":"Leanne","family":"Sakzewski","sequence":"first","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7819-6045","authenticated-orcid":false,"given":"Rose","family":"Gilmore","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Rehabilitation Service, Queensland Children\u2019s Hospital, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Hilton","sequence":"additional","affiliation":[{"name":"Queensland Paediatric Rehabilitation Service, Queensland Children\u2019s Hospital, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Goodman","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5344-9907","authenticated-orcid":false,"given":"Koa","family":"Whittingham","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqui","family":"Barfoot","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3529-7257","authenticated-orcid":false,"given":"Bianca","family":"Thompson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afroz","family":"Keramat","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-5975","authenticated-orcid":false,"given":"Roslyn N","family":"Boyd","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"2025070104270732000_15.2.e081843.1","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1089\/neu.2016.4692","article-title":"Social Competence at Two Years after Childhood Traumatic Brain Injury","volume":"34","author":"Anderson","year":"2017","journal-title":"J Neurotrauma"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.2","DOI":"10.1017\/S1355617712001531"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.3","DOI":"10.1111\/j.1469-8749.2009.03399.x"},{"key":"2025070104270732000_15.2.e081843.4","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.ejpn.2015.12.003","article-title":"Behavioral and emotional problems in children and adults with cerebral palsy","volume":"20","author":"Weber","year":"2016","journal-title":"Eur J Paediatr Neurol"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.5","DOI":"10.1089\/neu.2011.2144"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.6","DOI":"10.1111\/dmcn.12600"},{"key":"2025070104270732000_15.2.e081843.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0094936","article-title":"Suicidality, bullying and other conduct and mental health correlates of traumatic brain injury in adolescents","volume":"9","author":"Ilie","year":"2014","journal-title":"PLoS One"},{"key":"2025070104270732000_15.2.e081843.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.ridd.2022.104218","article-title":"Social skills group training in adolescents with disabilities: A systematic review","volume":"125","author":"Gilmore","year":"2022","journal-title":"Res Dev Disabil"},{"key":"2025070104270732000_15.2.e081843.9","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1177\/1087054715588188","article-title":"Friendship-Building Program for Adolescents With ADHD","volume":"23","author":"Gardner","year":"2019","journal-title":"J Atten Disord"},{"key":"2025070104270732000_15.2.e081843.10","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1111\/dmcn.15144","article-title":"Program for the Education and Enrichment of Relational Skills for adolescents with an acquired brain injury: A randomized controlled trial","volume":"64","author":"Gilmore","year":"2022","journal-title":"Dev Med Child Neurol"},{"key":"2025070104270732000_15.2.e081843.11","doi-asserted-by":"crossref","first-page":"5491","DOI":"10.1007\/s10803-022-05666-0","article-title":"Brief Report: A Pilot Study Examining the Effects of PEERS\u00ae for Adolescents Telehealth for Autistic Adolescents","volume":"52","author":"Adler","year":"2022","journal-title":"J Autism Dev Disord"},{"key":"2025070104270732000_15.2.e081843.12","doi-asserted-by":"crossref","first-page":"5232","DOI":"10.1007\/s10803-022-05580-5","article-title":"Efficacy of PEERS\u00ae for Adolescents via Telehealth Delivery","volume":"52","author":"Estabillo","year":"2022","journal-title":"J Autism Dev Disord"},{"key":"2025070104270732000_15.2.e081843.13","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1037\/rep0000414","article-title":"Adapting intervention approaches to new contexts: Three case studies of international adaptation of the Teen Online Problem Solving (TOPS) program","volume":"66","author":"Wade","year":"2021","journal-title":"Rehabil Psychol"},{"unstructured":"McGovern D . Randomized controlled trials. In: McGovern D , Valori R , S WSM , eds. Key topics in evidence based medicine. Oxford: BIOS Scientific Publishers, 2001: 26\u20139.","key":"2025070104270732000_15.2.e081843.14"},{"unstructured":"Thorne S . Interpretive description: qualitative research for applied practice, 2nd edn. New York, NY: Routledge, 2016.","key":"2025070104270732000_15.2.e081843.15"},{"doi-asserted-by":"crossref","unstructured":"Wechsler D . Wechsler abbreviated scale of intelligence (R): Second Edition (WASI(R)-II). San Antonio, TX: NCS Pearson, 2011.","key":"2025070104270732000_15.2.e081843.16","DOI":"10.1037\/t15171-000"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.17","DOI":"10.1177\/000841749005700207"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.18","DOI":"10.1111\/dmcn.13237"},{"key":"2025070104270732000_15.2.e081843.19","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1111\/dmcn.13157","article-title":"Impact of multi-modal web-based rehabilitation on occupational performance and upper limb outcomes: pilot randomized trial in children with acquired brain injuries","volume":"58","author":"Sakzewski","year":"2016","journal-title":"Dev Med Child Neurol"},{"key":"2025070104270732000_15.2.e081843.20","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-018-1213-9","article-title":"Effectiveness of Cognitive Orientation to daily Occupational Performance over and above functional hand splints for children with cerebral palsy or brain injury: a randomized controlled trial","volume":"18","author":"Jackman","year":"2018","journal-title":"BMC Pediatr"},{"unstructured":"Gresham F . SSIS social-emotional learning edition. Bloomington, MN: NCS Pearson, 2017.","key":"2025070104270732000_15.2.e081843.21"},{"key":"2025070104270732000_15.2.e081843.22","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1007\/s10826-010-9437-9","article-title":"Maternal Reports of Play Dates of Clinic Referred and Community Children","volume":"20","author":"Frankel","year":"2011","journal-title":"J Child Fam Stud"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.23","DOI":"10.1007\/s10803-014-2108-8"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.24","DOI":"10.1002\/(SICI)1098-2337(2000)26:2<169::AID-AB3>3.0.CO;2-A"},{"key":"2025070104270732000_15.2.e081843.25","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/00221325.2015.1007915","article-title":"Development of the Multidimensional Peer Victimization Scale-Revised (MPVS-R) and the Multidimensional Peer Bullying Scale (MPVS-RB)","volume":"176","author":"Betts","year":"2015","journal-title":"J Genet Psychol"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.26","DOI":"10.1007\/s11136-007-9241-1"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.27","DOI":"10.1007\/s11136-007-9240-2"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.28","DOI":"10.2165\/11599120-000000000-00000"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.29","DOI":"10.1007\/s10567-010-0071-2"},{"key":"2025070104270732000_15.2.e081843.30","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.apmr.2018.11.012","article-title":"Efficacy of Participation-Focused Therapy on Performance of Physical Activity Participation Goals and Habitual Physical Activity in Children With Cerebral Palsy: A Randomized Controlled Trial","volume":"100","author":"Reedman","year":"2019","journal-title":"Arch Phys Med Rehabil"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.31","DOI":"10.1007\/s10488-010-0319-7"},{"key":"2025070104270732000_15.2.e081843.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12912-015-0088-4","article-title":"The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice","volume":"14","author":"Breimaier","year":"2015","journal-title":"BMC Nurs"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.33","DOI":"10.1186\/1748-5908-7-37"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.34","DOI":"10.7326\/M17-0046"},{"doi-asserted-by":"publisher","key":"2025070104270732000_15.2.e081843.35","DOI":"10.1111\/j.1752-7325.2011.00233.x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081843","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T15:50:02Z","timestamp":1754495402000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081843"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,26]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bmjopen-2023-081843"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081843","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}