JMIR Publications

ABSTRACT

Background:

ADAPT (Aim to Decrease Anxiety and Pain Treatment) is a blended digital/live cognitive behavior therapy (CBT) treatment for children with functional abdominal pain disorders (FAPD) and anxiety. Initially developed and tested in USA pediatric gastroenterology settings, a Swedish language, culturally refined version was developed for use within a community-based pediatric primary healthcare setting.

Objective:

This study aimed to explore the preliminary impact and patient experiences of ADAPT in a Swedish community-based pediatric setting.

Methods:

Using a mixed-methods design, the study examines preliminary effect through a single-arm pre-post-test and treatment experience through semi-structured child interviews.

Results:

A total of 13 children (12 girls) participated in the intervention program and all participants completed the program. Seven of the participating children were then interviewed following intervention completion. Results showed a significant reduction in pain-related functional disability, with a median decrease from 14.00 pre-intervention to 5.00 post-intervention (P = .036, r = -0.58), and 46% achieving a clinically significant change. Pain intensity also significantly decreased from 6.5 to 4.00 (P = .016, r = -0.70), with 33.3% experiencing at least a 50% reduction. However, no statistically or clinically significant changes were observed in anxiety levels. Findings indicate clinically significant effect on measures of functional disability and average pain intensity. Qualitative analysis identified three themes: "Starting from scratch," "Experiencing the treatment," and "Getting on with life," highlighting participants' treatment experiences. 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 convergence 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, our findings provide a way forward for early, effective and accessible treatment for FAPD in a Swedish community-based pediatric setting.