Our prior research demonstrates low resilience among youth ages 12-17 with CMP, as well as a link between resilience and measures of disease burden (i.e. pain level and widespreadness of pain). In a single-arm pilot trial of PRISM, we demonstrated excellent feasibility and acceptability of the resilience coaching program among youth with CMP. We enrolled 69% of youth approached over a 6-month period (surpassing target enrollment rate of 25%); total n=27. Eighty-five percent of youth completed all required study visits. Video visit (71%) was the most frequent visit type. Mean participant satisfaction (rated 1=very unsatisfied and 5=very satisfied) was 4.27 (SD 0.94). Exploratory analyses suggested improvements in resilience and clinically relevant outcomes. Qualitative feedback was universally positive and supported our hypothesis that PRISM provides an alternative and acceptable psychosocial intervention for youth unable to access mental health services or perceive a stigma with it.  

We also have an ongoing research project, longitudinally assessing resilience and other psychosocial risk factors  among youth with CMP at time of initial clinic visit and again approximately 6 months later for adolescents diagnosed with CMP and one of their parents.

Patients and proxies will complete the Connor Davidson Resilience Scale 10-item (CD-RISC-10) and patient-reported outcome measures to assess resilience and treatment adherence. We will link our findings to information from the electronic medical record. We will also assess whether changes in resilience, and other psychosocial risk factors (i.e. pain catastrophizing, mindfulness, optimism, etc.), are associated with a number of symptoms and factors important to patients with CMP including pain intensity, physical disability, health-related quality of life, symptom severity, widespreadness of pain and parental resilience.

Findings from this study will complement the execution of K23-funded pilot randomized controlled trial of PRISM among adolescents with CMP that will 1) evaluate the efficacy of PRISM-C, 2) explore for which patients PRISM is most beneficial, and 3) examine implementation outcomes and identify barrier and facilitators to engagement to inform future implementation efforts. Youth will be randomized to usual care alone or usual care plus PRISM. The team will administer the intervention via telehealth. The team will also interview subjects upon completion to gain additional feedback to help reformat the intervention as needed.

The goal of this body of research is to contribute unique knowledge regarding risk factors associated with long term outcomes in adolescent CMP and identify ways to support adolescents with CMP.