ICANCOPE: RANDOMIZED CONTROLLED TRIAL OF A SMARTPHONE AND WEB-BASED APPLICATION TO MANAGE PAIN IN ADOLESCENTS AND YOUNG ADULTS (AYA) WITH CHRONIC PAIN

Leader(s): Jennifer Stinson
Institution(s): Hospital for Sick Children (site lead), Centre for Global eHealth Innovation (University Health Network), Alberta Children’s HospitalMount Sinai HospitalIWK Health CentreQueen Elizabeth II Health Sciences CentreAlberta Health ServicesStollery Children’s Hospital
Other Members: Lalloo, C.; Campbell, F.; Gordon, A.; Chorney, J.; Clark, J.; Simmonds, M.; Rashiq, S.; Jibb, L.; Dick, B.; Forgeron, P.; Ingelmo, P.; Montgomery, L.; Ruskin, D.; Tupper, S.; Victor, C.; Ware, M.; Palermo, T.



Why was the study done?
Chronic pain is common in young people aged 15-25 years. This pain can negatively impact all aspects of life. However, the developmental periods of adolescence and emerging adulthood also represent a critical window of opportunity to develop positive self-management behaviours and prevent future pain-related disability.

 

How was the study done?
iCanCope is a smartphone and web-based program designed to support young people with chronic pain. iCanCope was developed with extensive input from young people and healthcare providers. First, interviews and focus groups were completed to better understand the needs of this group. Second, a series of iCanCope design sessions were completed with patient partners to develop the final program. iCanCope features include: (i) symptom tracking and trends, (ii) goal-setting, (iii) coping skills toolbox, (iv) social community forum, and (v) chronic pain education.

 

What were the study results?
iCanCope is currently being rigorously evaluated through a randomized controlled trial supported by the CPN SPOR. This study will determine how the iCanCope program impacts the lives and self-management behaviours of young people aged 15-25 with chronic pain. Study recruitment is ongoing at 10 specialized chronic pain clinics across Canada. To date, 229 participants out of our target enrolment of 302 participants have been enrolled in our study. Preliminary analysis demonstrates that iCanCope can be deployed to participants with high fidelity (92% success) and this group demonstrates moderate-to-high program adherence over the 55-day study period. Post-study interviews are being conducted with a subset of participants to investigate program impact and satisfaction. Following completion of the trial, iCanCope will be made freely available to the public. iCanCope will increase the accessibility of pain self-management care for young people with chronic pain across Canada. 



Recent Updates:

 

The iCanCope with Pain program is being adapted and tested in five countries, including Canada, the United States of America, Ireland, Australia and Norway. 


Last updated: January 2021


Selected Publications:
  • Lalloo C, Mesaroli G, Stinson J (2020). Outcome measures for pediatric pain: Practical guidance on clinical use. Arthritis Care & Research. Invited book chapter.
  • Baggott C, Jibb L, Parker R, Stinson J, Linder L (2020). Technology to Support the Care of Children and Adolescents with Cancer. In P Hinds, L Linder (Eds.), Pediatric Oncology Nursing. Pediatric Oncology. Springer, Cham.
  • Twycross A, Saul R, Stinson J. (2020). Management of pain in children. In E.A Glasper, J. Richardson & D. Randall (eds.), The Textbook of Children and Young People's Nursing, 3rd edition, Elsevier, Edinburgh (In press).
  • Jibb LA, Stinson JN (2020). Digital health technologies for pediatric pain. In B Stevens, P McGrath and S Walker (Eds.), The Oxford Textbook of Paediatric Pain 2nd edition. Oxford: Oxford University Press.
  • Lalloo C, Harris L, Hundert A, Berard R, Cafazzo J, Connelly M, Feldman B, Houghton K, Huber A, Laxer R, Luca N, Schmeling H, Spiegel L, Tucker L, Pham Q, Davies-Chalmers C, Stinson J. The iCanCope pain self-management application for adolescents with Juvenile Idiopathic Arthritis: A pilot randomized controlled trial. Rheumatology (In Press). Accepted 14 March 2020.
  • Slater H, Stinson JN, Jordan JE, Chua J, Low B, Lalloo C, Pham Q, Cafazzo JA, Briggs AM. Evaluation of digital technologies tailored to support young people’s self-management of musculoskeletal pain: a mixed-methods design. Journal of Medical Internet Research (Preprint), 2020, https://preprints.jmir.org/preprint/18315. DOI: 10.2196/preprints.18315.
  • Lalloo C, Pham Q, Cafazzo J, Stephenson E, Stinson J. A ResearchKit app to deliver paediatric electronic consent: Protocol of an observational study in adolescents with arthritis. Contemporary Clinical Trials Communications, 2020, 17:100525, https://doi.org/10.1016/j.conctc.2020.100525
  • Bueno M, Stevens B, Barwick MA, Riahi S, Li SA, Lanese A, Willan A, Synnes A, Estabrooks CA, Chambers C, Harrison D, Yamada J, Stinson J, Campbell-Yeo M, Noel M, Gibbins S, LeMay S, Isaranuwatchai W. A cluster randomized clinical trial to evaluate the effectiveness of the Implementation of Infant Pain Practice Change (ImPaC) Resource to improve pain practices in hospitalized infants: A study protocol. Trials, 2020, 21(16): 1-11. https://doi.org/10.1186/s13063-019-3782-9
  • Grasaas E, Fegran L, Helseth S, Stinson J, Martinez S, Lalloo C, Haraldstad K. iCanCope With Pain: Cultural Adaptation and Usability Testing of a Self-Management App for Adolescents With Persistent Pain in Norway. JMIR Research Protocols (JRP), 2019, 8(6):e12940, https://doi.org/10.2196/12940.
  • Noel M, Rosenbloom B, Pavlova M, Campbell F, Isaac L, Pagé G, Stinson J, Katz J. Remembering the pain of surgery one year later: a longitudinal examination of anxiety in children’s pain memory development. PAIN, 2019, https://doi.10.1097/j.pain. 0000000000001582 [Epub ahead of print].
  • Birnie KA, Campbell F, Nguyen C, Lalloo C, Tsimicalis A, Matava C, Cafazzo J, Stinson J. ‘iCanCope PostOp’: User-centered design of a smartphone-based app for self-management of postoperative pain in children and adolescents. JMIR Formative Research, 2019, 3(2): e12028. https://pubmed.ncbi.nlm.nih.gov/31008704/
  • Tutelman P, Chambers C, Urquhart R, Fernandez C, Heathcote L, Noel M, Flanders A, Guilcher G, Schulte F, Stinson J, MacLeod J, Stern M. When “A Headache is Not Just a Headache”: A Qualitative Examination of Parent and Child Experiences of Pain after Childhood Cancer. Psycho-Oncology, 2019, 28(9): 1901-1909, https://doi.org/10.1002/pon.5170