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Boerner KE, Desai U, Luu J, MacLean KE, Munzner T, Foladare H, Shen J, Gill J, Oberlander TF. "Making Data the Drug": A Pragmatic Pilot Feasibility Randomized Crossover Trial of Data Visualization as an Intervention for Pediatric Chronic Pain. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1355. [PMID: 37628354 PMCID: PMC10452969 DOI: 10.3390/children10081355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
Data tracking is a common feature of pain e-health applications, however, viewing visualizations of this data has not been investigated for its potential as an intervention itself. We conducted a pilot feasibility parallel randomized cross-over trial, 1:1 allocation ratio. Participants were youth age 12-18 years recruited from a tertiary-level pediatric chronic pain clinic in Western Canada. Participants completed two weeks of Ecological Momentary Assessment (EMA) data collection, one of which also included access to a data visualization platform to view their results. Order of weeks was randomized, participants were not masked to group assignment. Objectives were to establish feasibility related to recruitment, retention, and participant experience. Of 146 youth approached, 48 were eligible and consented to participation, two actively withdrew prior to the EMA. Most participants reported satisfaction with the process and provided feedback on additional variables of interest. Technical issues with the data collection platform impacted participant experience and data analysis, and only 48% viewed the visualizations. Four youth reported adverse events not related to visualizations. Data visualization offers a promising clinical tool, and patient experience feedback is critical to modifying the platform and addressing technical issues to prepare for deployment in a larger trial.
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Affiliation(s)
- Katelynn E. Boerner
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Unma Desai
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jessica Luu
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Karon E. MacLean
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Tamara Munzner
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Haley Foladare
- Department of Computer Science, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Jane Shen
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
| | - Javed Gill
- BC Children’s Hospital, Vancouver, BC V6H 3N1, Canada
| | - Tim F. Oberlander
- Department of Pediatrics, BC Children’s Hospital Research Institute, University of British Columbia, Vancouver, BC V6H 3V4, Canada; (K.E.B.)
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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de la Vega R, Serrano-Ibáñez ER, Ruiz-Párraga GT, Palermo TM, Wicksell R, Fernández-Jiménez E, Oliva S, Roldán S, Monfort L, Peláez MJ, Leyva Carmona M, Ramírez-Maestre C, López-Martínez AE, Miró J, Esteve R. Protocol for a multi-phase, multi-center, real-world, hybrid effectiveness-implementation study of a digital intervention for pediatric chronic pain co-designed with patients (Digital SPA). Digit Health 2023; 9:20552076231219490. [PMID: 38130799 PMCID: PMC10734335 DOI: 10.1177/20552076231219490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023] Open
Abstract
Background Children and adolescents with chronic pain are a vulnerable population who often lack the resources to manage their condition. Due to high personal, social, and economic consequences, proper management in its early stages is key to reducing disability. The aim of this project is to co-develop a digital intervention for pediatric chronic pain (Digital SPA) with end-users and to evaluate its effectiveness and implementation outcomes in Spain. Methods (Phase 1) Focus groups with patients, parents, and clinicians (n = 5-6 each) will inform about unmet pain care needs and provide a starting point for co-designing the intervention. (Phase 2) Content creation and usability testing will be based on the results of Phase 1, and the theory-driven development will follow the latest available evidence. The intervention will use validated psychological techniques focused on improving functioning by teaching pain coping skills. (Phase 3) Hybrid effectiveness-implementation trial. Participants (n = 195) will be adolescents aged 12-17 years old with chronic pain and one of their parents. Assessments include physical function, pain, sleep, anxiety, mood, satisfaction and adherence to the treatment, and number of visits to the emergency room. A qualitative framework analysis will be conducted with data from Phase 1. Effects of the intervention will be evaluated using linear multilevel modeling. The Consolidated Framework for Implementation Research (CFIR) and Behavioral Interventions Using Technology (BIT) frameworks will be used to evaluate implementation. Discussion This study is expected to produce a co-created evidence-based digital intervention for pediatric chronic pain and a roadmap for successful implementation. Trial registration number TRN and date of registration ClinicalTrials.gov (registered on 26 June 2023: https://clinicaltrials.gov/study/NCT05917626). Contributions to the literature The implementation of digital health interventions has two major gaps: (1) adherence to treatment is suboptimal, and (2) the process of making the interventions available to the end-user in a sustainable way is often unsuccessful.In this study, we expect that assessing users' needs and co-designing an intervention with them will improve adherence.Documenting the implementation process from the project inception and integrating the results into an implementation framework will allow for replication and extension in different contexts.This study will increase the knowledge about implementation in a vulnerable population: adolescents with chronic pain without access to in-person multidisciplinary pain care.
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Affiliation(s)
- Rocío de la Vega
- Facultad de Psicología y Logopedia, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Elena R. Serrano-Ibáñez
- Facultad de Psicología y Logopedia, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Gema T. Ruiz-Párraga
- Facultad de Psicología y Logopedia, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Tonya M. Palermo
- Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA
| | - Rikard Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Pain Clinic, Capio St Göran Hospital, Stockholm, Sweden
| | - Eduardo Fernández-Jiménez
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Silvia Oliva
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
- Hospital Materno Infantil del Hospital Regional Universitario, Málaga, Spain
| | - Susana Roldán
- Hospital Materno Infantil Virgen de las Nieves, Granada, Spain
| | | | - María José Peláez
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
- Hospital Materno Infantil del Hospital Regional Universitario, Málaga, Spain
| | | | - Carmen Ramírez-Maestre
- Facultad de Psicología y Logopedia, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Alicia E. López-Martínez
- Facultad de Psicología y Logopedia, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA Plataforma BIONAND), Málaga, Spain
| | - Jordi Miró
- Universitat Rovira i Virgili, Tarragona, Spain
- Unit for the Study and Treatment of Pain–ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Institut d’Investigació Sanitària Pere Virgili, Tarragona, Spain
| | - Rosa Esteve
- Hospital Universitario Materno Infantil Torrecárdenas, Almería, Spain
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