Evaluating a virtual stepped care portal in youth awaiting tertiary chronic pain care: An Implementation-Effectiveness Hybrid Type III study
Pain is one of the most common symptoms of extreme stress in youth. Without treatment, acute pain will become chronic (CP; pain lasting >3 months), a problem already affecting 1 in 5 Canadian youth. The COVID‑19 pandemic is one of the greatest threats to youth mental health seen in generations. CP in childhood can trigger a wave of mental health issues that carry forward into adulthood. In 2019, we learned that “access to pain care” is poor and a priority for youth with CP and their families. Unfortunately, COVID‑19 has only made access more difficult. In 2020, we created an online “stepped care” program called the Power over Pain Portal. Stepped care is a promising way to improve access to CP care by tailoring care based on each person’s symptom severity. Like a ladder, a person may start with one type of care and then “step up” or “step down” to more or less intense care depending on what they need. Over the past year, we worked with hundreds of youth and healthcare professionals across Canada to understand how the pandemic has affected pain and mental health. We also summarized all online pain self-management programs including peer support for youth to find the best resources to include in the Portal. Together with a diverse group of youth, we have now co-designed the online Portal. The next step (focus of this grant) is to test the Portal with youth to ensure it can be implemented well and is helpful. We will also translate the Portal into French. We will recruit 72 youth with CP waiting for specialist care at 11 CP clinics across Canada to use the Portal for 4 months. We will see how they use the Portal and if it helps to improve their pain and mental health. This study is important because it will allow us to understand how the Portal works in the real world before wide public release (English and French) to support all youth in Canada with CP with accessible, evidence-based pain care.