These behavioral risk factors were consistent with observed patterns of mortality and chronic disease among AI/AN persons. All are amenable to public health intervention.

Results support the feasibility of the program, because participants were able to successfully meet with their coaches and use the app to develop and accomplish social participation goals. Further research will be needed to refine the app and program, particularly when reaching out to populations beyond traumatic brain injury. (PsycINFO Database Record

BackgroundAlthough pediatric brain tumor survivors are at high risk for a variety of psychosocial and neurocognitive late effects, there are few evidence‐based interventions to address their needs. The purpose of this study was to test the efficacy of an online problem‐solving intervention on improving the quality of life and executive dysfunction among adolescent and young adult brain tumor survivors.ProcedureA Survivor's Journey was adapted from a similar intervention for survivors of traumatic brain injuries, and involved self‐guided web modules providing training in problem‐solving as a tool for coping with everyday challenges, as well as weekly teleconferences with a trained therapist. Survivors (n = 19) between the ages of 13 and 25, and their caregivers, completed standardized measures of their emotional and behavioral functioning, executive functioning, and quality of life before and after the 12‐ to 16‐week intervention.ResultsParticipation in the intervention led to significant improvements in self‐reported overall (Mpre = 62.03, SDpre = 17.67, Mpost = 71.97, SDpost = 16.75; d = 0.58, P = 0.01) and physical quality of life (Mpre = 63.13, SDpre = 21.88, Mpost = 75.00, SDpost = 21.33; d = 0.55, P < 0.01) as well as parent‐reported emotional quality of life (Mpre = 65.00, SDpre = 28.72, Mpost = 76.15, SDpost = 23.47; d = 0.43, P = 0.03). Greater improvement was noted in those who were diagnosed before the age of seven and those with average or above average estimated IQs. Current age did not moderate outcomes.ConclusionsOnline problem‐solving therapy may be efficacious in improving pediatric brain tumor survivors’ quality of life; however, further research with a comparison group is needed. Online interventions such as Survivor's Journey may decrease barriers to evidence‐based psychosocial care for brain tumor survivors.

To describe the preliminary feasibility and acceptability of a web-based, problem-solving intervention for adolescent and young adult pediatric brain tumor survivors. Methods: With feedback from survivors and stakeholders, we created "A Survivor's Journey" by modifying an existing problem-solving intervention for traumatic brain injury. Survivors (ages 13-25) were recruited from a pediatric survivorship clinic and were eligible if they had self or caregiver-reported psychosocial difficulties. A Survivor's Journey has four core sessions (i.e., introduction, problem-solving, positive thinking, memory) and up to seven supplemental sessions. Each session involved web content and videoconferencing with a doctoral-level therapist. We analyzed postintervention data related to feasibility (i.e., enrollment and completion rates), as well as survivor's ratings of satisfaction and usability of the intervention. Results: Nineteen survivors (M age ϭ 17.57), half of eligible participants, agreed to

Findings support the usability of SPAN, which has the potential to improve social participation of adolescents with a history of TBI through an innovative use of technology and peer coaching.