JMIR Publications

ABSTRACT

Background:

Levels of self-perceived psychological resilience are low to moderate among youth with chronic musculoskeletal pain (CMP). Furthermore, resilience has been associated with symptom severity in CMP. Resilience coaching programs may therefore be of benefit in the non-pharmacologic management of adolescent CMP and may serve as an adjunctive way to access mental health services in an approachable and affordable way.

Objective:

The main goal of the study is to assess the feasibility, acceptability, and preliminary efficacy of the resilience coaching program called Promoting Resilience in Stress Management (PRISM) and to obtain the data needed to plan a larger trial.

Methods:

The Resilience Coaching for Adolescents with Chronic Musculoskeletal Pain pilot study is an investigator initiated, two-arm, randomized controlled trial (RCT) of PRISM in the interdisciplinary management of chronic musculoskeletal pain among adolescents. The study compares usual care versus PRISM plus usual care among adolescents newly diagnosed with CMP in the outpatient setting. One caregiver per patient is also enrolled. The control group receives usual care with no specific intervention. The treatment arm receives PRISM, which is a remotely delivered, one-on-one resilience coaching program, consisting of four required skill-based sessions and an optional final session. Sessions are delivered every 1-2 weeks, lasting about 3 months total. The primary outcome is the functional disability (FDI) score at 3 months post randomization. The secondary objectives are to evaluate potential patient and caregiver-level moderators of PRISM and identify facilitators and barriers to engagement in PRISM. The estimated sample size is 60 patient-caregiver dyads per group for a total of 120 dyads.

Results:

The trial is currently open; initial institutional review board approval on 4/21/2023; protocol version 4 amended 01/14/25. Recruitment began on 05/08/2023 and anticipated recruitment completion on 06/01/2025.

Conclusions:

Resilience coaching has demonstrated excellent feasibility, acceptability, and efficacy in teens with chronic illness however evidence to support its use in adolescent CMP is lacking. Resilience coaching has the potential to improve patient outcomes in this population. This pilot RCT will demonstrate acceptability, feasibility, preliminary efficacy and reveal critical barriers and facilitators to engagement. This will inform a larger multisite trial to evaluate definitive efficacy of the intervention. Clinical Trial: This study was registered at ClinicalTrials.gov (NCT05834725) on April 28, 2023; https://clinicaltrials.gov/study/NCT05834725.