The National Child Traumatic Stress Network website provides resources and products on child traumatic stress to both domestic and global audiences. Between October 2011 and September 2012, web analytics showed that 17% of website visitors were from outside the US, with the top three non-US countries being Australia, India, and the Philippines. Visitors from outside English-speaking countries spent more time on the site and viewed more pages than one-time visitors. The site appears to have a global reach and value in raising standards of care for traumatized children worldwide.

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GLOBAL REACH OF NATIONAL CHILD TRAUMATIC STRESS NETWORK RESOURCES AND PRODUCTS
Cathryn Chiesa, MLS, National Center for Child Traumatic Stress, Duke University, Nathalie Reid, MA, MLIS, National Center for Child
Traumatic Stress, UCLA, Lisa Richardson, MS, RD National Center for Child Traumatic Stress, Duke University
BACKGROUND
Established by Congress in 2000 the NCTSN
seeks to improve the quality, effectiveness,
and availability of care and services for
children and families who are exposed to a
wide range of traumatic experiences.
As the national resource for public and
professional education, NCTSN offers a wide
range of on-line materials for multiple
audiences. The NCTSN website contains
over 500 pages where visitors can download
more than 200 products.
EVALUATION QUESTIONS
What is the global reach of the electronic
dissemination of products, services, and
information via the www.nctsn.org website?
How and to what degree do foreign visits
differ from domestic visits?
METHODS
Authors used web analytics to track and map
material access from outside the United
States between October 1, 2011 to
September 30, 2012 (a federal fiscal year).
Content reports for website visitors by
country, landing pages, keywords searched,
and referral traffic were compared and
contrasted.
CONCLUSIONS
To the best of our knowledge, no other single
website contains this amount of material
concerning one of the most pervasive and
treatable public health problems affecting not
only our nation’s children and families, but
also those around the world. Despite its
exclusive design for an American audience,
the site appears to have global reach and
value. Also, noteworthy is the recognition of
the NCTSN name as well as the reach of the
Measures Review Database. Together these
results underscore the value of utilizing
NCTSN resources and products in achieving
the mission of raising the standard of care
and access to services for traumatized
children and their families.
Who visits www.nctsn.org?
When it can be determined, where do visitors land?
Rank Country
1 United States
1 Australia
1 Colombia
2 Hong Kong
1 Germany
1 India
1 Japan
1 Netherlands
4 Philippines
1 South Africa
2 New Zealand
1 Italy
1 Canada
1 United Kingdom
Rank Country
3 United States
3 Australia
3 India
10 Netherlands
2 Philippines
2 South Africa
1 New Zealand
8 Italy
3 Canada
2 United Kingdom
www.nctsn.org//resources/audiences/parents-
caregivers/understanding-child-traumatic-stress
www.NCTSN.org
Rank Country
7 United States
4 Australia
8 India
1 Philippines
4 South Africa
8 New Zealand
7 Canada
7 United Kingdom
http://www.nctsn.org/trauma-types
When keywords can be determined, most visitors find the website by using key word permutations of the NCTSN name. This includes visits from outside the
United States. Approximately 30% of visits from large English speaking countries appear to result from key word searches for specific clinical screening or
assessment tools, such as the Beck Depression Inventory and the Difficulties in Emotion Regulation Scale, found in the Measures Review Database.
Between October 1, 2011 and September 30, 2012, 17% of website visitors were from outside the US with English speaking countries making up 60% of
that total. New visitors exceeded return visitors for all countries except Columbia. For counties with at least 1,00 visitors, the average time spent by return
visitors and the number of pages visited was greater than new visitors.
CanadaColumbia
Return visitors stay on average 9
minutes, exceeding US visitors by 4
minutes.
7 of the top 10 landing pages are on
topics of clinical assessment.. In
contrast US landing pages focus on
more general topical issues and public
awareness.
Most referral traffic comes from the
NCTSN Facebook page and
represents the most frequent referral
source for visits from outside the
United States.
In addition to significant similarities in visitor flow, Canada and the United States
have seven out of the top ten landing pages.