Impact of coping profiles on social identity in a youth chronic pain recommender system: qualitative descriptive...

Chronic pain affects one in five children and adolescents worldwide yet remains one of the most underrecognized and undertreated illnesses, emphasizing the need for accessible, personalized digital health support. The Power over Pain portal delivers such support through a virtual stepped-care pathway, but like many digital interventions, is vulnerable to declining user engagement over time. Health recommender systems (HRSs) can personalize resource delivery and combat "choice overload," thereby encouraging sustained use. This study investigates the application of a health recommender system (HRS) as a way of increasing engagement with relevant virtual care resources for pediatric chronic pain. The perceived value of the HRS was evaluated through a qualitative descriptive study involving ten participants diagnosed with chronic pain.

Thematic analysis revealed four main themes: (1) HRS serves as a catalyst for important dialogue in routine care; (2) coping results from the HRS are selectively applied by users according to their needs; (3) the HRS creates a personable experience, positively influencing willingness to engage in care; (4) interacting with the HRS may affirm participants' social identities, fostering a sense of belonging in the pain community and potentially enhancing long-term resource engagement.

These findings challenge the traditional focus on recommendation accuracy alone, suggesting instead that the effectiveness of an HRS may also be influenced by design features that support validation, shared experience, and potential social identification, which can deepen engagement and promote involvement in care. Future work should investigate the impact of mechanisms that reinforce users' social identities to understand their effects on sustained use and self-management behaviors.