(PS3-51) Barriers and Facilitators Influencing Provider Usage of Pediatric Pain-focused Cognitive Behavioral Therapy Strategies in a School Settings

Background/Rationale: Cognitive behavioral therapy (CBT) strategies can help reduce symptoms associated with childhood chronic pain. Schools may be an optimal setting to increase reach, but pain-focused CBT is not yet routinely implemented. Our team is engaging school providers in such training. To optimize implementation of these strategies, it is crucial to understand how factors such as provider knowledge, self-reported barriers and facilitators may be related to intervention use.

Objective: Aim 1) report on provider knowledge, self-reported barriers and facilitators related to use following a comprehensive training in pain-focused CBT. Aim 2) investigate if provider knowledge, barriers and facilitators are related to skill usage after one month.

Method: Providers (n = 104) participated in the Helping Educators Learn Pediatric Pain Assessment and Intervention Needs (HELP PAIN) training program, a cognitive behavioral training on skills to manage pediatric pain. After training, they completed the Feasibility of Intervention Measure (FIM; Weiner et al., 2017), reported perceived barriers/facilitators to implementing HELP PAIN strategies, and took a knowledge quiz on the program. One month later, they reported their usage of the CBT strategies. Demographics, provider knowledge, and barriers/facilitators to program use will be reported, along with the association between these factors and skill usage after 1 month using a point-biserial correlation.

Preliminary

Results: Majority of providers identified as White (79%) and female (86%). The average age of providers was 42 years (range 24-66).

Aim 1) Feasibility.  Providers reported on the intervention’s feasibility with an average score of M = 17.2 (SD = 2.5) on a 20-point scale.

Barriers to treatment. Out of ten potential barriers, providers reported an average of M = 2.8 (SD= 1.7) barriers. The most common barriers included: the child has complex health issues (27%), or the child has a developmental delay (26%).

Knowledge Providers completed a 20-item HELP PAIN knowledge assessment following training, with an average score of 70%.

Usage of intervention. 42% of providers reported using at least 1 HELP PAIN strategy after 1 month, with an average usage of M=4.3 (SD = 2.74) skills. The most common strategies included: deep breathing (90%) and pain ratings (71%).

Aim 2) There was no association between provider knowledge, self-reported feasibility, and number of barriers with whether or not any skills were used after one month (all p’s > 0.05).

Implications: This project is an important first step towards understanding barriers and facilitators of using cognitive behavioral strategies for pain management.  Additional investigation will be analyzed to identify factors that might promote program implementation.