Digital Solution for Pain in Adolescents (Digital SPA)

The content of the intervention will be aligned with and based on the latest available evidence and guidance by the Cochrane Collaboration Reports on remotely delivered interventions for pediatric chronic pain, the WHO guidelines on the management of chronic pain in children, and the input provided by the users. Combining literature-informed evidence-based techniques (particularly cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT)) with user input is key to improve user’s acceptance and adherence with the intervention, which are some of the main problems digital health faces. Specifically, Digital SPA will build on a pain learning theory framework and align with ACT and the fear–avoidance model in its focus on exposure and psychological flexibility. Digital SPA will be focused on improving functioning by teaching pain coping skills, and will likely include skills such as relaxation and mindfulness, goal setting based on life values, sleep management, behavioral activation, self-management of negative thoughts and emotions (e.g., accepting them as part of life, learning to be defused with them), and communication skills. Digital SPA could also include the ability to track symptoms and set up reminders. Digital SPA is designed as a standalone intervention, that is, participants will not have the option to interact with a therapist, and all the elements are self-guided and independent on other interventions. To facilitate future dissemination, Digital SPA will be designed to be optimized for both Android and iOS, will have accessibility features (e.g., text to voice, color-blind display options, subtitles, and any other adaptations determined in the co-design), and be prepared to support multi-lingual content for a potential future expansion to other languages. An accompanying intervention website for parents is being created as well. It is based on the content and format of the adolescents’ intervention. In the parents’ website, parents will be guided through what their child is learning each week and provided with strategies to support them to learn the new skills. Additionally, a section on communication and self-care as caregivers will be provided. The website will be responsive, optimized to be accessed with a phone. This project began in 2022 and is being developed by a team of researchers and clinicians from the University of Málaga (UMA) and the Biomedical Institue of Málaga (IBIMA), other collaborating hospitals and international advisors. The principal investigator is Dr. Rocío de la Vega. The target group are children and adolescents with chronic pain and their parents. Children can access to a self-management intervention using a Smartphone app. Parents can access to a website with an intervention for parents.