A Multisite Implementation of the Comfort Ability Program Telehealth Intervention for Pediatric Chronic Pain:...

The primary aim of this multisite study was to evaluate the feasibility and acceptability of a telehealth adaptation of the Comfort Ability Program (CAP) workshop, a group-based and family-based, in-person, behavioral health intervention for pediatric pain and related symptoms.

Four pediatric medical centers recruited patients (ages: 10 to 17; n=137) and their caregivers (n=139) for CAP-Virtual (CAP-V), a 6-session telehealth intervention. Families completed acceptability, feasibility, and clinical assessments at 4 time points: (1) pretreatment, (2) postsession, (3) immediately post-treatment, and (4) 1-week post-treatment. Clinicians also completed ratings of telehealth engagement.

Patients, caregivers, and clinicians overwhelmingly rated CAP-V as a highly feasible and acceptable intervention. The overwhelming majority (95%+) completed 75% or more of the multisession intervention, and 58% were able to have multiple caregivers from the same household participate. There were a few technological issues that significantly impacted either the content or social connectedness of group participants.

The CAP intervention can be delivered through telehealth with rates of acceptability and feasibility that are analogous to the in-person intervention. Cross-site and aggregate participant responses from this investigation helped to further refine virtual intervention content and structure. Overall, findings from this study support the maintenance and expansion of access to telehealth care-specifically for specialized behavioral health interventions that may be difficult to access-by demonstrating high rates of patient participation, satisfaction with intervention and technology, and successful attainment of intervention goals as rated by patients and providers. Additional research is needed to assess long-term clinical outcomes.