Trauma-Informed Pediatric Pain Intervention: Development and Refinement of an Intervention for Pediatric Cancer

Objective: Pediatric cancer and treatment involve many painful procedures, which can cause youth, family, and provider distress. Evidence-based, developmentally tailored, and trauma-informed pain management strategies are not consistently implemented in pediatric cancer treatment. The Trauma-Informed Pediatric Pain Intervention (TIPPI) aimed to address these unmet needs for families (TIPPI-F) and providers (TIPPI-P). This study details the design and initial evaluation of TIPPI using Phase 1 of The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral health interventions. Methods: In Phase 1a, we defined the core components of the proposed treatments and designed the treatment and evaluation protocols. In Phase 1b, we conducted testing with small cohorts of families ( n = 12) and nurses ( n = 12). Clinical outcome data, participant feedback, and observational data collected by the study team were gathered for both family and provider interventions to inform future refinement. Results: Families who completed TIPPI-F reported decreased treatment anxiety, but no change in distress or pain and hurt. Feedback highlighted TIPPI-F strengths, such as detailing advocacy strategies for families, and identified areas for growth, including timing of delivery. Providers who completed TIPPI-P reported increased competence in TIC and decreased perceived barriers to implementing TIC. Provider feedback reflected they appreciated reviewing strategies for identifying patient distress. Conclusions: TIPPI-P is ready to proceed to Phase II to establish proof-of-concept in a larger trial, while refinement of TIPPI-F is needed using data obtained in preliminary testing. Use of the ORBIT model will continue to guide the development of this behavioral health intervention.