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      <dc:title>A digital health psychological intervention (WebMAP Mobile) for children and adolescents with chronic pain: Results of a hybrid effectiveness-implementation stepped wedge cluster randomized trial.</dc:title>
      <dc:creator>Palermo, Tonya M.</dc:creator>
      <dc:creator>De la Vega, Rocío</dc:creator>
      <dc:creator>Murray, Caitlin B.</dc:creator>
      <dc:creator>Law, Emily</dc:creator>
      <dc:creator>Zhou, Chuan</dc:creator>
      <dc:subject>Telemedicina</dc:subject>
      <dc:subject>Dolor en niños</dc:subject>
      <dc:description>Although psychological treatments benefit youth with chronic pain, treatment is not accessible in most communities. Digital health&#xd;
interventions offer promise for expanding access and reach to this population. Using a stepped-wedge cluster randomized trial&#xd;
design, we evaluated effectiveness and implementation of a digital health delivered psychological intervention for pediatric chronic&#xd;
pain. One hundred forty-three youth, aged 10 to 17 years, with chronic pain and a caregiver were recruited from 8 clinics in the&#xd;
United States. Active intervention included access to the Web-based Management of Adolescent Pain (WebMAP) Mobile app and&#xd;
the WebMAP parent web site to learn pain self-management skills. Effectiveness outcomes included pain intensity, disability, and&#xd;
patient global impression of change, while Reach, Adoption, Implementation, and Maintenance were implementation outcomes.&#xd;
Results showed that youth in both treatment conditions (WebMAP vs Usual Care) had similar changes over time in pain and&#xd;
disability. Youth in the WebMAP condition perceived greater improvement (patient global impression of change) at post-treatment&#xd;
and follow-up (d’s 5 0.54 and 0.44, P , 0.05) compared with youth receiving usual care. Use of the digital health intervention was&#xd;
modest and variable; approximately 30% of youth and parents completed treatment. Greater engagement (number of completed&#xd;
modules) was associated with significantly greater reductions in pain and disability from pre-treatment to follow-up (d’s520.57 and&#xd;
20.38, P , 0.05). Parents, youth, and providers found treatment acceptable; providers had positive attitudes and demonstrated&#xd;
referrals over a maintenance period. Further research is needed to understand how to enhance treatment engagement with digital&#xd;
health interventions and optimize implementation.</dc:description>
      <dc:date>2025-03-20T10:04:08Z</dc:date>
      <dc:date>2025-03-20T10:04:08Z</dc:date>
      <dc:date>2020</dc:date>
      <dc:type>journal article</dc:type>
      <dc:identifier>Palermo T.M., de la Vega, R., Murray, C., Law, E.F., Zhou, C. (2020). A digital health psychological intervention (WebMAP Mobile) for children and adolescents with chronic pain: Results of a hybrid effectiveness-implementation stepped wedge cluster randomized trial. Pain, 161(12), 2763–2774. PMID: 32658147. doi: 10.1097/j.pain.0000000000001994</dc:identifier>
      <dc:identifier>https://hdl.handle.net/10630/38175</dc:identifier>
      <dc:identifier>10.1097/j.pain.0000000000001994</dc:identifier>
      <dc:language>eng</dc:language>
      <dc:rights>http://creativecommons.org/licenses/by-nc-nd/4.0/</dc:rights>
      <dc:rights>open access</dc:rights>
      <dc:rights>Attribution-NonCommercial-NoDerivatives 4.0 Internacional</dc:rights>
      <dc:publisher>Lippincott, Williams &amp; Wilkins</dc:publisher>
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