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Trial registered on ANZCTR
Registration number
ACTRN12624000253505
Ethics application status
Approved
Date submitted
14/02/2024
Date registered
14/03/2024
Date last updated
14/03/2024
Date data sharing statement initially provided
14/03/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Pain Smart: Integrating pain education and clinical care for adolescents with pain at schools.
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Scientific title
Pain Smart: Integrating pain education and clinical care for adolescents with pain at schools.
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Secondary ID [1]
311289
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APP2017114
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Universal Trial Number (UTN)
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Trial acronym
PAIN SMART
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pain
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Condition category
Condition code
Public Health
329218
329218
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0
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Health promotion/education
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Anaesthesiology
329762
329762
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: Pain education module and parents resources
The Pain Smart education module contains evidence-based information about pain aligned with the biopsychosocial model. Module content has been informed by previous studies about adolescents’ understanding of and experiences with pain, and their preferences for learning about pain conducted prior to this study. The module has been designed in collaboration with education specialists to ensure congruence with the NSW Personal Development, Health and Physical Education (PDHPE) curriculum, and mapped to the current NSW PDHPE syllabus.
Students in both schools will receive three to four lessons to develop their knowledge and understanding of pain, factors that influence the experience of pain and strategies to manage pain. The pain education will be general in nature with no individual content or tailoring. The delivery of the lessons will be multimodal; including teacher presentations, videos, class discussions, and individual and learning activities designed by an education specialist. The lesson content will be provided by the research team to the PDHPE teachers at participating schools. The PDHPE teachers will deliver the content to the students during usual PDHPE classes, one hour per week, for 4 consecutive weeks during one school term.
Given parents strongly influence how their children learn to respond to pain, a PDF summary of key concepts from the education module will be emailed to the parents within the first week of education module. Lesson attendance marked by the teacher will be used to monitor adherence.
Arm 2: Pain education module and parents resources + Biopsychosocial Care
Students in school B who report pain that impacts their lives at baseline will be contacted by a study case manager.
A registered health professional with experience treating chronic pain will serve as a case manager for students who report problems with pain. The intervention will be consistent with the WHO guidelines for management of chronic pain in children; biopsychosocial assessment and management, care given by healthcare providers skilled and experienced in chronic pain, comprehensive and integrated care, and an interdisciplinary, multimodal approach to pain management. The telehealth consults with the case manager for assessment an care will be conducted on a secure videoconferencing platform. It will be at the discretion of the student if their parent is present during the consult. Care will be provided through one 30 min consult per week, over a one-month period (4 weeks) and tailored to individual needs. The case manager will record attendance to monitor adherence.
The case manager will:
1. Conduct a biopsychosocial assessment, including screening for serious pathology that requires urgent medical attention and mental health.
2. Provide validation, reassurance and information consistent with the participant’s condition and the pain education module.
3. Use principles of goal setting, cognitive behavioural therapy, and motivational interviewing to help the adolescent recover from their condition and return to usual activities.
4. Refer to other health professionals, specialist services and/or further investigations as required.
If pain has resolved by the time the case manager contacts the student, the student declines case management or the case manager assesses the student does not require further follow up, no further management will be provided.
Arm 3: No intervention
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Intervention code [1]
327737
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Treatment: Other
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Comparator / control treatment
Control group will receive the same intervention after the end of the study (after the 12 month follow up), but no intervention during the study period. They will continue to receive their usual PDHPE lessons from the NSW curriculum.
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Control group
Active
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Outcomes
Primary outcome [1]
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Chronic Pain Risk
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Assessment method [1]
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Paediatric Pain Screening Tool (PPST)
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Timepoint [1]
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Baseline, 3-month and 12-month post-intervention commencement
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Primary outcome [2]
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Pain interference
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Assessment method [2]
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PROMIS Paediatric Pain Interference Scale-Short Form (PPPI)
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Timepoint [2]
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Baseline, 3-month and 12-month post-intervention commencement
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Primary outcome [3]
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Pain understanding
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Assessment method [3]
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Conceptualisation of Pain Questionnaire (COPAQ)
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Timepoint [3]
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Baseline, 3-month and 12-month post-intervention commencement
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Secondary outcome [1]
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Health-related quality of Life
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Assessment method [1]
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5-Dimension health-related quality of life instrument for Young people (EQ-5D-Y-3L)
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Timepoint [1]
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Baseline, 3-month and 12-month post-intervention commencement
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Secondary outcome [2]
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Depression and anxiety (composite secondary outcome)
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Assessment method [2]
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Patient Health Questionnaire-4 (PHQ-4)
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Timepoint [2]
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Baseline, 3-month and 12-month post-intervention commencement
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Secondary outcome [3]
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School absence due to pain
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Assessment method [3]
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A modified question (item 8) from the Presence and Impact of Pain in Kids (PIP-Kids) questionnaire: “have you missed school due to pain in the last month”.
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Timepoint [3]
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Baseline, 3-month and 12-month post-intervention commencement
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Secondary outcome [4]
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Alcohol consumption and smoking behaviours (composite secondary outcome)
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Assessment method [4]
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A question from the Alcohol, Smoking and Substance Involvement Screening Test - Youth (ASSIST-Y)
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Timepoint [4]
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Baseline, 3-month and 12-month post-intervention commencement
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Secondary outcome [5]
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Physical activity and sedentary behaviours (composite secondary outcome)
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Assessment method [5]
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Two items from the NSW School Students Health Behaviour Survey (SSHBS)
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Timepoint [5]
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Baseline, 3-month and 12-month post-intervention commencement
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Eligibility
Key inclusion criteria
Participants will be students attending mainstream secondary schools in years 7-9 (ages 11-15). Selection of this participant age group is pragmatic, correlating with the first three years of secondary school and stages 4 and 5 of the New South Wales (NSW) Personal Development, Health, and Physical Education (PDHPE) syllabus. All students will receive the pain education module as part of their usual PDHPE class and data will be collected from consenting students and respective parents/caregivers. Students with language difficulties will be supported by the schools’ Learning Support Officer.
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Minimum age
11
Years
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Maximum age
15
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
No students attending the study schools will be excluded from the study.
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The allocation concealment will be performed through a central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The sequence generation will be performed using a simple randomisation using a randomisation table created by computer software (i.e. computerised sequence
generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/08/2024
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Actual
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Date of last participant enrolment
Anticipated
3/08/2026
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Actual
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Date of last data collection
Anticipated
2/08/2027
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Actual
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Sample size
Target
3000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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The Commonwealth of Australia Medical Research Future Fund (MRFF) for Research Activities
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Address [1]
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RG Casey Building John McEwen Crescent Barton ACT 0221 Australia
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Sydney
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Address
Level 3, Margaret Telfer Building, K07, 79 Arundel Street, Forest Lodge NSW 2037
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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NHRMC
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Address [1]
317629
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Country [1]
317629
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314442
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The University of Sydney Human Research Ethics Committee
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Ethics committee address [1]
314442
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https://www.sydney.edu.au/research/research-integrity-and-ethics.html
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Ethics committee country [1]
314442
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Australia
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Date submitted for ethics approval [1]
314442
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25/09/2023
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Approval date [1]
314442
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06/11/2023
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Ethics approval number [1]
314442
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2023/781
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Summary
Brief summary
This study is a multi-site parallel group cluster randomized trial delivering pain education and biopsychosocial care to students attending secondary schools. This school-based intervention aims to provide the opportunity for all adolescents to access accurate and evidence-based information about pain and pain management. This study is a three-arm parallel group cluster randomized trial, with economic evaluation. Participating schools will be randomly allocated to 1) pain education module and parent resources, 2) pain education module and parent resources, plus biopsychosocial care for students reporting problems with pain, or 3) no intervention.
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Trial website
painsmart-education.sydney.edu.au
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Steven Kamper
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Address
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The University of Sydney and NBMLHD - 62 Derby St, Kingswood, NSW 2747, Australia
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Country
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Australia
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Phone
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+61 0411383044
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Tie Parma Yamato
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Address
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The University of Sydney and NBMLHD - 62 Derby St, Kingswood, NSW 2747, Australia
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Country
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Australia
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Phone
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+61 0404138248
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Tie Parma Yamato
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Address
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The University of Sydney and NBMLHD - 62 Derby St, Kingswood, NSW 2747, Australia
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Country
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Australia
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Phone
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+61 0404138248
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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