Perceptions of Adolescents With Cancer Related to a Pain Management App and Its Evaluation: Qualitative Study Nested Within a Multicenter Pilot Feasibility Study.

Lindsay A Jibb,Vanessa Hum,Joseph A Cafazzo,Donna L Johnston,Paul C Nathan,Jennifer N Stinson,Bonnie J Stevens,Emily Seto

doi:10.2196/mhealth.9319

Lindsay A Jibb, Vanessa Hum + Show 6 more

Open Access

https://doi.org/10.2196/mhealth.9319

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Abstract

BackgroundPain in adolescents with cancer is common and negatively impacts health-related quality of life. The Pain Squad+ smartphone app, capable of providing adolescents with real-time pain management support, was developed to enhance pain management using a phased approach (ie, systematic review, consensus conference and vetting, iterative usability testing cycles). A 28-day Pain Squad+ pilot was conducted with 40 adolescents with cancer to evaluate the feasibility of implementing the app in a future clinical trial and to obtain estimates of treatment effect.ObjectiveThe objective of our nested qualitative study was to elucidate the perceptions of adolescents with cancer to determine the acceptability and perceived helpfulness of Pain Squad+, suggestions for app improvement, and satisfaction with the pilot study protocol.MethodsPost pilot study participation, telephone-based, semistructured, and audio-recorded exit interviews were conducted with 20 adolescents with cancer (12-18 years). All interviews were transcribed and independently coded by 2 study team members. Content analysis was conducted to identify data categories and overarching themes.ResultsFive major themes comprising multiple categories and codes emerged. These themes focused on the acceptability of the intervention, acceptability of the study, the perceived active ingredients of the intervention, the suitability of the intervention to adolescents’ lives, and recommendations for intervention improvement.ConclusionsOverall, Pain Squad+ and the pilot study protocol were acceptable to adolescents with cancer. Suggestions for intervention and study improvements will be incorporated into the design of a future randomized clinical trial (RCT) aimed at assessing the effectiveness of Pain Squad+ on adolescents with cancer health outcomes.

Highlights

BackgroundUp to 96% of adolescents with cancer experience pain related to the disease or associated invasive procedures and treatment [1]
Overall, Pain Squad+ and the pilot study protocol were acceptable to adolescents with cancer
This study has demonstrated the acceptability and perceived helpfulness of the Pain Squad+ intervention and pilot study protocol to adolescents with cancer, albeit with a few caveats and suggestions for improvement

Summary

Introduction

BackgroundUp to 96% of adolescents with cancer experience pain related to the disease or associated invasive procedures and treatment [1]. Treatment advancements and health care system transformations have resulted in adolescents with cancer receiving much of their care on an outpatient basis [12]. This change may mean that a significant proportion of adolescent cancer symptoms (including pain) are experienced in an environment where management options may be suboptimally applied (eg, at home). Adolescents with cancer have emerged as a childhood cancer subgroup with unique developmental characteristics and a unique cancer epidemiology [13,14,15] These characteristics suggest that the cancer pain experience and appropriate management techniques may be different for adolescents when compared with younger children and adults [15,16,17]. A 28-day Pain Squad+ pilot was conducted with 40 adolescents with cancer to evaluate the feasibility of implementing the app in a future clinical trial and to obtain estimates of treatment effect

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