A Digital Therapy Platform to Improve Access to Cognitive Behavioral Treatment for Youth with Chronic Headaches - Project Summary Frequent, severe headaches are among the most common pediatric medical concerns, affecting ~12 million U.S. youth and leading to significant disability that often persists or worsens into adulthood. Cognitive Behavioral Therapy for Headache (CBT-HA) improves daily functioning, quality of life, and mental health outcomes, and increases the likelihood of headache reduction ninefold compared to medication or education alone. Yet, access to CBT-HA remains severely limited. Barriers include reliance on a small doctoral-level workforce of headache specialists, geographic maldistribution, and delivery systems not designed for scale or for pediatric populations. Youth in medically underserved areas and those treated outside top-ranked children’s hospitals face the steepest access gap. Existing digital health tools are fragmented and not condition-specific, leaving no streamlined system to deliver pediatric behavioral healthcare at scale. Streamind Health is developing an innovative digital behavioral health platform tailored for youth with chronic headaches and their caregivers. The platform consolidates essential tools, including (i) live video CBT-HA, (ii) integration with referring medical teams, and (iii) digital therapy tools and resources specific to pediatric headache. Unlike generic digital mental health solutions, the Streamind platform delivers evidence-based, condition-specific interventions designed for the unique needs of youth with chronic pain. Importantly, it will enable master’s-level clinicians–the largest segment of the behavioral health workforce–to deliver these treatments with consistency and fidelity, greatly expanding scalability and access. The overall objective of this Phase I SBIR is to develop and validate a minimum viable product (MVP) and test its usability with three target user groups. We will pursue the following aims: ● Aim 1: Develop a user-informed MVP. Wireframes and a clickable prototype will be iteratively refined using feedback from clinicians and youth-caregiver dyads. Milestones: completion of a compliant MVP demonstrating 99.9% 30 day availability, <1% critical error rate, load time <2 seconds, and similar. ● Aim 2: Conduct usability testing and iterative refinement. Two cycles of usability testing with clinicians and youth-caregiver dyads will assess PACMAD (People at the Centre of Mobile Application Development) dimensions (i.e., acceptability, efficiency, learnability) and guide iterative improvements. Milestones: achievement of a System Usability Scale (SUS) score ≥68 across user groups, supported by convergent positive qualitative feedback. This proposal will yield a fully functional, optimized prototype ready for clinical efficacy testing. Long-term, this project will deliver the first condition-specific, scalable digital behavioral health platform for pediatric headache, expanding the headache-specific mental health workforce, improving treatment access, and transforming care for medically complex youth.
