Telemedicine Optimized Burn Intervention

Looking at the number of child participants in each condition that experienced adverse events, serious adverse events, and unexpected problems. Adverse events in this study included infection, delay in wound care or non-healing wound. Adult caregivers are not included in this as they did not have burn wounds that were assesssed.

Time frame: Assessed weekly until burn wound was healed, up to 35 days

Looking at the number of participants retained in the study versus those lost to attrition

Time frame: From enrollment to 30 days after burn wound has healed (up to 35 days after enrollment).

Population: Parents/caregivers and patients were considered to be enrolled together as a dyad, but are reported here as caregiver and patient.

Looking at the number of participants (parents and children) who agree to enroll in the study at the time of burn injury versus the total number of participants who were approached to participate in the study.

Time frame: At enrollment

Population: This includes caregivers and their children.

Looking at the number of times providers or participants experienced and reported technological problems with TOBI

Time frame: Assessed weekly until burn wound was healed, up to 35 days

Population: Only participants in the TOBI arm were evaluated for issues with technology as the face to face group did not interact with technology.

Looking at the percentage of patient/caregiver dyads who adhered to prescribed burn wound care treatment protocol. A wound care fidelity checklist was used at each visit to determine the percentage of wound care adherence per visit. These percentages were then averaged for each weekly visit to give the value below.

Time frame: Assessed weekly at clinic/telemedicine visit until burn wound was healed, up to 35 days after injury

Looking at the change in group average scores on the Attitudes Towards Technology and Telemedicine Questionnaire (caregiver-reported) from baseline to 1 month follow-up. Scores may range between 26-130, with higher scores = more positive attitudes towards technology and telemedicine.

Time frame: Measured at baseline and 1-month follow-up

Looking at average caregiver's perception of child's pain score at follow up visits between the two groups using the Wong-Baker Scale (0-10, with higher scores = more pain). Most dyads only attended one follow up visit but if more than one, the average score is reported below.

Time frame: Measured during the treatment phase (week 1 clinic visit)

Looking at average scores on the Client Satisfaction Questionnaire-8 scores (caregiver-reported). Scores range between 8-32, with higher scores = greater satisfaction.

Time frame: Measured at 1-month follow-up only

Looking at the direct cost to patient/caregiver as reported by caregiver

Time frame: From enrollment through treatment phase (weeks 1-4)

Looking at average scores on the MAUQ questionnaire measuring app usability (caregiver-reported in TOBI condition only). Raw scores range between 21-147 and average scores range between 1-7, with higher overall score equivalent to higher usability of the app. The average scores and standard deviation are reported below for the TOBI group.

Time frame: Measured at 1-month follow-up only

Population: The face-to-face arm did not use the TOBI app at all, therefore they did not take the MAUQ to rate the app.

Looking at the number of days it takes for wound to heal following burn injury in both conditions

Time frame: Measured during the treatment phase (2-4 weeks)

Looking at the number of times participants had unscheduled visits (in the ED or the clinic)

Time frame: Measured during the treatment phase (2-4 weeks)

Looking at the number of wound complications (e.g., infection, conversion to deeper burn requiring surgery, conversion to deeper burn requiring a change in therapy).

Time frame: Measured during the treatment phase (2-4 weeks)

Looking at the baseline and 1-month follow up scores on the Patient-Reported Outcomes Measurement Information System (PROMIS)-Anxiety questionnaire (caregiver-reported). Each item on the measure is rated on a 5-point scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) range in score from 7 to 35 with higher scores indicating greater severity of anxiety. The raw scores on the 7 items should be summed to obtain a total raw score. Next, the T-score table is used to identify the T-score associated with the individual's total raw score. The mean T-scores is 50 with a standard deviation of 10. T-scores range between 36.3-82.7. T scores are interpreted as follows: \<55 (none to slight anxiety), 55-59.9 (mild anxiety), 60-69.9 (moderate anxiety), \>70 (severe anxiety). T scores and standard error are reported below.

Time frame: Measured at baseline and 1-month follow-up

Looking at the baseline and 1-month follow up scores on the Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression questionnaire (caregiver-reported). Each item on the measure is rated on a 5-point scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) with a range in score from 8 to 40 with higher scores indicating greater severity of depression. The raw scores on the 8 items should be summed to obtain a total raw score. Next, the T-score table is used to identify the T-score associated with the individual's total raw score. The mean T-scores is 50 with a standard deviation of 10. T-scores range between 37.1-81.1. T scores are interpreted as follows: \<55 (none to slight depression), 55-59.9 (mild depression), 60-69.9 (moderate depression), \>70 (severe depression). T scores and standard error are reported below.

Time frame: Measured at baseline and 1-month follow-up

Looking at the baseline and 1-month follow up scores on the Patient-Reported Outcomes Measurement Information System (PROMIS)-General Self Efficacy questionnaire (caregiver-reported). Each item on the measure is rated on a 5-point scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) range in score from 8 to 40 with higher scores indicating greater self efficacy. The raw scores on the 7 items should be summed to obtain a total raw score. Next, the T-score table is used to identify the T-score associated with the individual's total raw score. The mean T-scores is 50 with a standard deviation of 10. T-scores range between 22.72-64.98. A T-score value of 55 indicated that the respondent has greater self-efficacy for managing emotions. Higher scores indicating more self efficacy and lower scores with less self efficacy. T scores and standard error are reported below.

Time frame: Measured at baseline only

Looking at the baseline and 1-month follow up scores on the Patient-Reported Outcomes Measurement Information System (PROMIS)-Self-Efficacy Managing emotions questionnaire (caregiver-reported). Each item on the measure is rated on a 5-point scale (1=never; 2=rarely; 3=sometimes; 4=often; and 5=always) range in score from 4-20 with higher scores indicating greater severity of anxiety. The raw scores on the 4 items should be summed to obtain a total raw score. Next, the T-score table is used to identify the T-score associated with the individual's total raw score. The mean T-scores is 50 with a standard deviation of 10. T-scores range between 36.3-82.7. A T-score of 55 and greater indicates that the respondent has greater self efficacy and ability to manage their emotions regarding disease. A higher score than 55 indicates even more self efficacy and lower score, less. T scores and standard error are reported below.

Time frame: Measured at baseline only

Looking at average pain score at follow up visits between the two groups using the Wong-Baker Scale (0-10, with higher scores = more pain). Most patients only attended one follow up visit but if more than one, the average score is reported below.

Time frame: Measured during the treatment phase (week 1 clinic visit)

Looking at average scores on the Perceived Stress Scale (caregiver-reported) between two conditions. Scores on the PSS can range from 0 to 40 with higher scores = higher perceived stress. Scores ranging from 0-13 would be considered low stress. Scores ranging from 14-26 would be considered moderate stress. Scores ranging from 27-40 would be considered high perceived stress.

Time frame: Measured at 1-month follow-up only

Looking at the change in group average scores on the Barriers to Care Questionnaire (BCQ), Pragmatics Subscale (caregiver-reported). Scores range from 0-100, with higher scores = fewer barriers and problems with access.

Time frame: Measured at baseline and 1-month follow-up

Looking at average scores on the Peritraumatic Distress Inventory (caregiver-reported). Scores range between 0-52, with higher scores = greater peritraumatic distress. An optimal cutoff score of 23 (sensitivity = 71%; specificity = 73%) is good for predicting clinically elevated PTSD 30-days post-injury.

Time frame: Measured at baseline only

Looking at the group average scores on the PANAS questionnaire measuring positive and negative affect (caregiver-reported). The means of the positive and negative scores for PANAS are reported below along with standard deviations. The scores range between 10-50, with higher scores = higher levels of affect (both positive and negative). For positive affect, a higher score is a better outcome and for negative affect, a lower score is a better outcome. Scores are reported for baseline and 1 month after burn wound healing.

Time frame: Measured at baseline/enrollment and 1-month follow-up.

Average scores on the Posttraumatic Growth Inventory (caregiver-reported). Scores range from 0-105, with higher scores = greater posttraumatic growth.

Time frame: Measured at 1-month follow-up only

Looking at the average time it took patient/caregiver to return to work after burn wound injury.

Time frame: From enrollment through the treatment phase (weeks 1-4). This included any time that the parent had was out of work because of the injury at time of occurrence or due to clinic follow up.

Looking at the total number of face-to-face visits

Time frame: Treatment phase (weeks 2-4)

Looking at the total number of TOBI visits

Time frame: Treatment phase (weeks 2-4)

Population: This outcome only pertains to the TOBI arm as the face-to-face arm did not have any TOBI visits.

Looking at the total travel time in each condition as reported by the caregiver.

Time frame: From enrollment through treatment phase (weeks 1-4)