Background: The Comfort Ability Program (CAP) workshop was created at BCH in 2011 as a CBT-based group intervention for adolescents with chronic pain and their parents and has been disseminated to 21 pediatric hospitals internationally. We describe the application of the Knowledge-to-Action Cycle (K-AC) for the systematic adaptation of CAP to a virtual format (V- CAP) to address the need for telehealth care during the COVID-19 pandemic. We illustrate how the K-AC framework guided the workshop adaptation, resulting in clinical feasibility and high patient satisfaction.
Methods: The in-person workshop includes simultaneous but separate 6-hour interventions for adolescents and parents. The V-CAP adaptation includes two 3-hour telehealth weekend sessions for parents and four 2-hour telehealth weekday sessions for adolescents delivered over two weeks. Pivoting to virtual administration via the K-AC included six reiterative processes: 1) Identify problems (no access to in-person care); 2) Assess barriers to knowledge use (group telehealth); 3) Tailor interventions and implementation procedures (content refinement, administration procedures, training and transfer protocols for dissemination); 4) Monitor knowledge use (clinical fidelity, implementation flexibility); 5) Evaluate outcomes (participant satisfaction, clinical impact); 6) Sustain knowledge use (implementation maintenance, research, ongoing innovation).
Results: Since April 2020, 52 families have participated in nine interventions facilitated at BCH (M=13.85, SD=2.11). Adolescents reported confidence in managing the pain (Strongly Agree=37%, Agree=43%) and parents reported confidence in making changes to the way they handle their child’s pain (Strongly Agree=54%, Agree=44%). Parents reported satisfaction with the virtual format (Strongly Agree=60%, Agree=29%). Currently, nine hospitals in the CAP network have adopted V-CAP.
Conclusions: The K-AC successfully guided the transition of CAP from an in-person intervention to V-CAP, a modified telehealth program, while maintaining participant satisfaction and cross- institutional dissemination. A multisite study to further inform the K-AC for V-CAP is ongoing.
Live Zoom Session – April 21st
Maureen Burns, BS, BA, Samantha P. Bento, PhD, Simona Bujoreanu, PhD, Amy E. Hale, PhD, Rachael Coakley, PhD
Rachael Coakley, PhD