User-centered development of a digital exposure treatment for youth with chronic pain

Chronic pain affects the lives of over a quarter of youth, with societal costs exceeding $19.5 billion dollars in the U.S. each year. Many barriers limit access to available efficacious behavioral interventions, highlighting the critical need to develop digitally delivered versions to increase reach. Graded exposure treatment targets pain-related impairment by exposing patients to previously feared and avoided activities. Our group is developing a digital prototype of an interdisciplinary outpatient graded exposure intervention (iGET Living). The purpose of this study is to present acceptability data from user-centered focus groups. Utilizing an iterative, user-experience design, we will collect acceptability data on treatment content and structure via qualitative interviews with adolescents. Data collection will proceed in iterations of n = 5-7 until the goal is met. Data included in the present study are from the first round of qualitative interviews (n = 6). Participants ranged in age from 10-15 years (50% female). Participants rated treatment content for clarity and satisfaction on a 0 (not clear/satisfied) to 4 (very clear/satisfied) scale after each module (10 modules in total). Open-ended questions assessing acceptability, ease of use, comprehensibility, and suggestions for improvement were collected. All treatment modules received a 3 or 4 out of 4 for clarity and satisfaction. Average satisfaction rating of the overall intervention was 7 out of 10 (10 = very satisfied) and 83% of participants said it would be feasible to complete on a daily basis. Common qualitative themes included: tailoring content to age groups, desire for engaging and interactive visuals, and inclusion of patient testimonials. Acceptability data is critical to refining the digital solution. The iterative development of key recommended features such as patient testimonials will ultimately lead to feasibility and preliminary effectiveness assessment of iGET Living for youth with chronic pain. Drotar-Crawford Postdoctoral Fellowship Research Grant in Pediatric Psychology.