Objective: Pediatric cancer and treatment involve many painful procedures, which can cause youth, family, and provider distress. Evidence-based, developmentally tailored, and trauma-informed pain management strategies are not consistently implemented in pediatric cancer treatment. The Trauma-Informed Pediatric Pain Intervention (TIPPI) aimed to address these unmet needs for families (TIPPI-F) and providers (TIPPI-P). This study details the design and initial evaluation of TIPPI using Phase 1 of The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral health interventions. Methods: In Phase 1a, we defined the core components of the proposed treatments and designed the treatment and evaluation protocols. In Phase 1b, we conducted testing with small cohorts of families (n = 12) and nurses (n = 12). Clinical outcome data, participant feedback, and observational data collected by the study team were gathered for both family and provider interventions to inform future refinement. Results: Families who completed TIPPI-F reported decreased treatment anxiety, but no change in distress or pain and hurt. Feedback highlighted TIPPI-F strengths, such as detailing advocacy strategies for families, and identified areas for growth, including timing of delivery. Providers who completed TIPPI-P reported increased competence in TIC and decreased perceived barriers to implementing TIC. Provider feedback reflected they appreciated reviewing strategies for identifying patient distress. Conclusions: TIPPI-P is ready to proceed to Phase II to establish proof-of-concept in a larger trial, while refinement of TIPPI-F is needed using data obtained in preliminary testing. Use of the ORBIT model will continue to guide the development of this behavioral health intervention.
Impact Statement
Optimizing pain management and reducing cancer-related distress during pediatric cancer treatment is essential, however, pediatric hospital systems often struggle with implementation of validated tools and comprehensive pain management practices. TIPPI aims to reduce family and provider distress associated with cancer-related pain and increase use of behavioral pain management strategies throughout cancer treatment. The current paper outlines the design and initial testing of evidence-based family and provider interventions to address these needs with small cohorts.
