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Agile Development of a Digital Exposure Treatment for Youth with Chronic Musculoskeletal Pain

Award Number: K23AR079608
ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 07/20/2021
PERIOD OF PERFORMANCE END DATE: 06/30/2026

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Agile Development of a Digital Exposure Treatment for Youth with Chronic Musculoskeletal Pain - Abstract Chronic musculoskeletal (MSK) pain affects the lives of over a quarter of youth, with societal costs exceeding $19.5 billion dollars in the U.S. each year. The impact of chronic MSK pain in adolescence is felt into adulthood and is a documented risk for opioid misuse. There are a number of efficacious behavioral interventions for adolescents with chronic pain, but many access-to-care barriers exist, highlighting the critical need to develop digitally delivered behavioral interventions to drastically increase reach. Graded exposure is a theory- driven, individually-tailored intervention for individuals with chronic pain targeting pain-related impairment by exposing patients to previously feared and avoided activities. This project seeks to develop and evaluate the feasibility and preliminary effectiveness of a digital exposure treatment (iGET Living) for adolescents with chronic musculoskeletal (MSK) pain and their parents, utilizing a sequential replicated and randomized single-case experimental design (SCED) and incorporating innovative technology for remote biomechanical assessment. The central hypothesis is iGET Living will be acceptable and feasible for youth with chronic MSK pain and their parents and will be effective at alleviating functional disability and pain-related distress. Agile research methods will allow for a rapid, iterative development and evaluation of the intervention, yielding a clinically useful solution. This proposal includes a comprehensive training plan under the guidance of mentors with expertise across study aims. Dr. Harrison will obtain specialized training in 1) user-centered design and agile development of digital interventions, 2) clinical research and trial execution, 3) intervention optimization, dissemination, and implementation science, 4) innovative, remote assessment of biomechanical function, 5) advanced qualitative and quantitative statistics, and 6) experiential learning in grant-writing. Research: Aim 1: In an iterative, user- experience design process, Dr. Harrison and her team will develop iGET Living for adolescents with chronic MSK pain and their parents. Data regarding comprehensiveness and acceptability will be collected via interviews with patients and parents. Clinicians specialized in pediatric chronic pain will provide feedback on how providers might integrate into practice, who they would refer, and potential barriers to utilization. Aim 2: Dr. Harrison will evaluate preliminary feasibility and effectiveness of iGET Living to reduce pain-related distress and functional disability utilizing SCED with multiple measures. Successful completion of these aims will provide the opportunity to rapidly evaluate treatment effectiveness and inform iterative development of iGET Living to prepare subsequent RCTs. The strong mentorship team, specialized career development training, and proposed research plan will allow Dr. Harrison to gain the expertise needed to seek R-level funding and achieve her long- term career goal of becoming an independent clinician-scientist with expertise in developing digital interventions for youth with chronic pain and their parents.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $152,355 )
2025	2025	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	5	6/17/2025	NON-COMPETING CONTINUATION	$152,355
														Subtotal = $152,355

Issue Date FY: 2024 ( Subtotal = $152,355 )
2024	2024	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	4	6/17/2024	NON-COMPETING CONTINUATION	$152,355
														Subtotal = $152,355

Issue Date FY: 2023 ( Subtotal = $152,355 )
2023	2023	THE LELAND STANFORD JUNIOR UNIVERSITY	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	3	6/23/2023	NON-COMPETING CONTINUATION	$152,355
														Subtotal = $152,355

Issue Date FY: 2022 ( Subtotal = $152,355 )
2022	2022	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	2	8/5/2022	NON-COMPETING CONTINUATION	$152,355
														Subtotal = $152,355

Issue Date FY: 2021 ( Subtotal = $152,355 )
2021	2021	LELAND STANFORD JUNIOR UNIVERSITY, THE	450 JANE STANFORD WAY	STANFORD	CA	94305	SANTA CLARA	USA	Arthritis, Musculoskeletal and Skin Diseases Research	000	1	7/20/2021	NEW	$152,355
														Subtotal = $152,355

Grand Total All Awards = $761,775

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Agile Development of a Digital Exposure Treatment for Youth with Chronic Musculoskeletal Pain

Award Number: K23AR079608

ORGANIZATION: NATIONAL INSTITUTE OF ARTHRITIS & MUSCULOSKELETAL & SKIN DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 07/20/2021

PERIOD OF PERFORMANCE END DATE: 06/30/2026

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