Document text
Principal Investigator: Emily O Wakefield
Organization: CONNECTICUT CHILDREN'S MEDICAL CENTER
Fiscal Year: 2024
Award: $129,828
Funding agency: National Institute of Arthritis and Musculoskeletal and Skin Diseases
ABSTRACT
Pain-related stigma is a significant and understudied psychosocial factor among adolescents with chronic
widespread musculoskeletal pain (CWMP) that has been implicated in impaired health outcomes. The
subjectivity of pain self-report increases the opportunity for an individual to experience symptom disbelief by
others. Pain-related stigma is a significant public-health priority due to its potential impact on delayed diagnosis
and impairment in recovery. Adolescents with CWMP are vulnerable to pain-related stigma from several
sources, including physicians, school staff, family, and peers, likely impacting their health. The objectives of
this proposal are to: 1) examine how pain-related stigma is a novel and necessary psychosocial component of
adolescent CWMP, and 2) develop and validate the Pain-Related Stigma Scale for Adolescents (PReSS-A) in
patients with CWMP. Not enough is known about pain-related stigma in this young population. This proposal
uses a mixed-methods design to develop a theoretical framework in new areas of psychosocial research for
adolescents with CWMP. This research will provide a foundation for understanding pain-related stigma and
developing interventions to target this social construct in adolescents with CWMP. The specific aims are: 1)
develop a pain-related stigma framework and PReSS-A items using separate focus groups of adolescents with
CWMP and juvenile idiopathic arthritis (JIA) and their parents; 2) refine PReSS-A items using classical item
analyses in a sample of adolescents with CWMP; 3) validate final PReSS-A items in a larger sample of
adolescents with CWMP, and test construct validity using a comparative sample of adolescents with JIA, who
are hypothesized to report less stigma due to the medical evidence supporting their JIA diagnosis; and 4)
leverage structural equation modeling to explore relationships between perceived pain-related stigma and
psychosocial and health outcomes. The use of multiple patient populations (i.e., CWMP and JIA) and their
parents to examine and validate a measure of this social construct is innovative. This career-development
award is designed to allow Dr. Emily Wakefield, a pediatric psychologist in the Division of Pain and Palliative
Medicine at Connecticut Children's Medical Center and Assistant Professor of Pediatrics at the University of
Connecticut School of Medicine, to draw upon ample resources of both institutions to become an independent
researcher dedicated to improving health outcomes for adolescents with chronic pain. Her short-term goal is to
understand mechanisms contributing to pain-related stigma and develop interventions focused on reducing this
stigma in adolescents with CWMP. To achieve this, the career-development plan includes formal and informal
training, mentorship and consultation in both qualitative and quantitative research design, and advanced
training on statistical analyses, pediatric pain, stigma, and randomized clinical trials. Her long-term goals are to
be a national leader in psychosocial research on pediatric chronic pain and an expert on adolescent pain-
related psychosocial health outcomes.
Terms: <0-11 years old><Adolescent><Adolescent Youth><Age><Anxiety><Area><Career Development Awards><Career Development Awards and Programs><Career Development Programs K-Series><Child><Child Youth><Childhood><Children (0-21)><Children's Hospital><Chronic><Chronic Childhood Arthritis><Clinical><Collaborations><Connecticut><Consultations><Dedications><Development Plans><Diagnosis><Diagnostic><Diffuse Myofascial Pain Syndrome><Disease><Disorder><Emotional Depression><Equation><Exhibits><Family><Fibromyalgia><Fibromyositis-Fibromyalgia Syndrome><Fibrositis><Focus Groups><Foundations><Functional impairment><Funding><Future><Goals><Grant><Health><Health Care Providers><Health Care Utilization><Health Personnel><Healthcare Providers><Healthcare worker><Impaired health><Impairment><Individual><Institution><Intervention><Intervention Strategies><Investigators><Judgment><Juvenile Chronic Arthritis><Juvenile Chronic Polyarthritis><Juvenile Rheumatoid Arthritis><K-Awards><K-Series Research Career Programs><MPD syndrome><Measures><Medical><Medical center><Mental Depression><Mentorship><Methods><Modeling><Muscular Rheumatism><Musculoskeletal Pain><NIAMS><National Institute of Arthritis, and Musculoskeletal, and Skin Diseases><Obesity><Outcome><Outcome Assessment><Pain><Pain Nature><Pain intensity><Painful><Palliative Medicine><Parents><Pathology><Patient Self-Report><Patients><Pediatric Hospitals><Pediatrics><Perception><Performance><Physicians><Population><Property><Provider><Psychologist><Psychometrics><Psychosocial Factor><QOL><Quality of life><Recovery><Reporting><Research><Research Career Program><Research Design><Research Personnel><Research Resources><Researchers><Resources><Role><Sampling><Schools><Self-Report><Site><Source><Statistical Data Analyses><Statistical Data Analysis><Statistical Data Interpretation><Stigmatization><Study Type><Symptoms><Testing><Training><Treatment outcome><Uncertainty><Universities><Work><Youth><Youth 10-21><adiposity><adolescent health outcomes><ages><anxiety symptoms><anxious symptom><assess effectiveness><authority><career development><childhood epilepsy><chronic pain><comparative><comparator group><comparison group><consultation><corpulence><cost><depression><depression symptom><depressive><depressive symptoms><design><designing><determine effectiveness><disability><disparity in health><doubt><effectiveness assessment><effectiveness evaluation><evaluate effectiveness><examine effectiveness><experience><fibromyalgia syndrome><health care personnel><health care service use><health care service utilization><health care worker><health disparity><health provider><health workforce><healthcare personnel><healthcare service use><healthcare service utilization><healthcare utilization><improved><innovate><innovation><innovative><interventional strategy><juvenile><juvenile arthritis><juvenile human><juvenile idiopathic arthritis><kids><medical college><medical personnel><medical schools><myofascial pain dysfunction syndrome><novel><parent><patient population><pediatric><pediatric epilepsy><peer><poor health outcome><professor><psychosocial><psychosocial variables><public health priorities><randomized, clinical trials><reduced health outcome><school of medicine><social><social factors><social relationships><social role><social stigma><statistical analysis><stigma><study design><treatment provider><worse health outcome><youngster>