(PS3-84) Bridging the Gaps: Enhancing Engagement in Post-trauma Mental Health Services Across Diverse Trauma Centers

Abstract Text: Each year, approximately 300,000 children suffer injuries severe enough to require hospitalization, with nearly one in three developing posttraumatic stress disorder (PTSD) and/or depression. These conditions significantly increase the risk of lost productivity, social and functional impairment, poor quality of life, and chronic disease. The risk is even greater for firearm injury survivors, who are twice as likely to develop PTSD or depression. Trauma centers are uniquely positioned to address the social and mental health needs of high-risk patients. To meet this need, our team developed the Trauma Resilience and Recovery Program (TRRP), an evidence-based stepped care model that includes: (1) in-hospital education and screening, (2) ongoing emotional recovery monitoring via automated text messaging, (3) a 30-day follow-up screening to identify patients in need of psychological care, and (4) connection to best-practice treatment. With support from a recent award (1R01HD102336-01A1; PI: Davidson), we partnered with three accredited Level I and II pediatric trauma centers to conduct a multi-site hybrid effectiveness-implementation trial with 300 adolescents (ages 12-17) to evaluate TRRP’s impact on emotional recovery. Site 1 is a large Level I trauma center located in an urban area in the Northeast, serving over 50,000 youth annually. Site 2, a Level II trauma center in a rural region of the Southeast, is home to one of the largest and most comprehensive multidisciplinary trauma teams in the area. Site 3 is a Level I trauma center in an urban setting in the Southeast, providing care for a high volume of pediatric firearm injury cases. The purpose of this poster is to present preliminary data on participation and engagement across all phases of TRRP, identify implementation challenges, and explore strategies to optimize program reach. A total of 85 number of adolescent injury survivors were randomized to TRRP condition. Participant engagement in TRRP services varied across the three trauma center sites based on key demographic and clinical factors. Across sites, younger participants and those with firearm-related injuries demonstrated lower engagement rates. Site 1, an urban Level I trauma center, had the highest completion rate of the 30-day screen (89%), while Site 2, a rural Level II center, had the lowest (59%). Positive PTSD and/or depression screens were most prevalent at Site 3 (59%), which also had the highest rate of treatment referral acceptance (71%). Gender differences were observed, with females more likely than males to complete the 30-day screen and accept treatment referrals across all sites. These findings highlight site-specific variations in engagement and underscore the need for tailored implementation strategies to enhance participation in post-trauma mental health services. This poster will discuss key barriers to engagement and explore strategies to optimize program reach across diverse trauma center settings.