Operationalizing Trauma-Informed Principles to Build Safe, Inclusive, and Equitable Patient Partnerships in Pediatric...

Advancing inclusion in pediatric pain research requires approaches that move beyond recruitment diversity toward authentic partnerships with youth and families whose lived experience can inform scientific rigor, relevance, and ethical integrity. Although patient engagement is widely endorsed, practical guidance for implementing partnerships that are safe, equitable, and sustainable remains limited, especially when working with populations exposed to intersectional marginalization and stigma. In this perspective, we argue that trauma-informed principles provide a critical framework for structuring meaningful patient partnerships in pediatric pain science. In collaboration with our patient partner (co-author, SS), we situate contemporary partnership approaches within their historical foundations in the justice-oriented movements that first recognized lived experience as a form of expertise. We then synthesize evidence describing benefits of patient engagement for research quality, feasibility, and translation, alongside emerging data on benefits for patient partners themselves. We use a case example from our lab to illustrate how patient partners can shape study design, language, recruitment, and ethical safeguards in ways that strengthen methodological and contextual validity. We also examine structural, relational, and emotional barriers that may limit equitable, rewarding participation if not intentionally addressed. In response to these barriers, we propose a partnership framework that links core trauma-informed care (TIC) principles (eg, safety, transparency/trustworthiness, peer support, collaboration, empowerment, cultural responsiveness) to actionable strategies and underlying mechanisms toward authentic engagement. We conclude inclusive partnership practices can help pediatric pain researchers to build collaborations that are ethically grounded, methodologically robust, and amplify the voices and priorities of youth living with pain.