The purpose of this research was to develop an innovative mobile health application (mHealth app), designed to provide self-management strategies for young people aged 10-14 living with persistent pain to improve pain and functioning and positively influence the wellbeing of the young person and their family. In children and adolescents, 8-38% of the population are affected by persistent pain, requiring frequent medical consultation and medication use [1,2]. Current treatment methods follow a multi-dimensional and interdisciplinary approach that encompasses biological, psychological and sociocultural factors within the individual’s developmental trajectory, while encouraging self-management [3,4]. However, barriers to accessing interdisciplinary pain treatments often mean that children leave clinical care without the skills required to successfully self-manage pain, and cope with symptoms (5,6). To improve access to treatment options, there is increasing support for mobile-based interventions in health care. Mobile-based interfaces, or mHealth applications, have been found to improve pain intensity and functioning in children and adolescents [7] however, no mHealth applications for children/adolescents with persistent pain are available for purchase or have undergone testing [8]. There is an evident need to address the important and challenging issue of persistent pain in children in clinical practice.
Methods:
The study used a three phased mixed-method design underpinned by a co-creation framework [9], and was conducted between March 2017 and September 2018. Phase 1: individual interviews with children aged 10-14 who experience persistent pain, their parents and/or adult family members, and a range of health care professionals were undertaken to explore the health care needs of children living with persistent pain, and seek their views on the content within the web- and mobile-based application. Phase 2: A multi-disciplinary Advisory Reference Group (ARG), comprised of children aged 10-14 who experience chronic pain, their parents and/or adult family members, and a range of health care professionals was used to provide feedback, advice and consensus on the mHealth app content from the needs assessment conducted in Phase 1. The outcomes of Phases 1 and 2 informed the design and development of the architecture and content of the mHealth app. Phase 3: Initial feasibility testing of the developed application and its architecture, involving a content review by the ARG, and in-field testing with a sample of n=6 children (aged 10-14). This presentation will outline the results of Phases 2 and 3.
Results:
Thirty- four stakeholder interviews were analysed using Norwood’s approach [10] to inductive analysis, the resultant themes were: mind-body scan, strategies, goal setting, social support, and engagement. Based on the needs identified in the thematic analysis, consultation with the ARG and consumer feedback, and current best practices for pain self-management the overall structure for the [mHealth] app was established. The structure incorporated four elements underpinned by the themes taken from interviews: (1) self-monitoring diary, (2) gym that included goal setting, strategies, notifications, achievements, resources and, (4) social.
Conclusion:
Based on interviews with young children aged 10 – 14 years, parents and health care professionals, and with overarching guidance from an expert advisory group, we have developed a mHealth application, myPainPal, for children aged 10 -14 years with persistent pain. The process used to co-create the myPainPal was an important relationship building research process, combining the knowledge and skills of researchers, clinicians, patients and staff to create a new and valuable resource for a vulnerable group of young children.