2. ADAPTing psychological treatment for functional abdominal pain in Swedish specialized pediatric care settings

Emma Ramsay Milford, Åsa Nilses, Sandra Buratti, Natoshia Cunningham, Ewa-Lena Bratt, Sandra Weineland

Keywords: Pediatric functional abdominal pain; digital intervention; cognitive behavior therapy; cultural adaption

Background:

ADAPT (Aim to Decrease Anxiety and Pain Treatment) is a blended digital/live cognitive behavior therapy (CBT) treatment for children, aged 9-14, with functional abdominal pain disorders (FAPD) and anxiety. Initially developed and tested in USA within pediatric gastroenterology settings, a Swedish language culturally refined version was developed for use within community-based pediatric healthcare settings. Pediatric FAPD is associated with health comorbidities, such as anxiety, are common and associated with adverse pain-related outcomes and increased risk of developing other pain conditions. Therefore developing and evaluating early treatment is of great importance. This study aimed to explore the impact of ADAPT and patient experiences.

Research questions:

What are the preliminary effects of ADAPT on measures of functional disability, pain intensity and anxiety?
What are participating children's perceptions of treatment content, format and outcomes?

Method:

A convergant mixed-methods approach was used with a quantitative single-arm pre- post-test design to explore preliminary treatment effect and a qualitive design with semi-structured child interviews to explore experience of the treatment.

Results:

Findings indicate statistically significant changes and clinically significant effect on measures of functional disability and average pain intensity. In terms of treatment experience, the blended live/digital format was a perceived as a good fit for youth. Most children described finding some strategy within the program that was effective for them and also reported positive outcomes, such as increased participation in school. There was good concordance between participants’ perceived experience and self-rated outcomes.

Conclusions:

As patient experiences were predominantly positive and quantitative results indicative of potential for increased function and reduced pain, the findings provide a way forward for early and accessible treatment for FAPD within Swedish community-based pediatric settings.

Points for discussion:

-Blended live/digital psychological treatment - children's perceived benefits

- Conducting clinical research: Limitations and possibilities

- Next steps: Moving forward and building on findings

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