Research

The Pediatric Pain Management Clinic (PPMC) at Stanford Medicine Children’s Health offers multiple research projects outlined below. Investigations aim to understand pediatric functioning over time as youth, caregivers, and families participate in medical and behavioral health treatment(s) offered through the PPMC, and/or intensive outpatient services offered in the Pediatric Pain Rehabilitation Program (PReP).

Pediatric Collaborative Health Outcomes Information Registry (Peds-CHOIR)

Principal Investigator: Rashmi Bhandari, PhD

Peds-CHOIR is an open platform, open source, learning healthcare system that tracks patient outcomes over time. This dynamic system improves upon healthcare providers' ability to offer precision medicine and patient-centered care for both youth as well as their parents/caregivers. Specifically, pediatric patients are empowered to work on improvements in functional (e.g., mobility, pain interference), emotional (e.g., anxiety, depression), sleep (e.g., chronic fatigue), and social (e.g., peer relations; school functioning) domains, while caregiver health is also captured and supported when indicated. Resilience factors are reinforced, while risk factors such as child and parent pain catastrophizing and fear-avoidance are reduced with evidence-based treatments such as Cognitive-Behavioral Therapy. Employed by an integrated team of medical professionals including pain physicians, psychologists, nurse practitioners, and physical therapists, the platform enables a multifactorial approach to child wellness in the treatment of pediatric chronic pain conditions.

Pediatric Pain Rehabilitation Program (PReP) Outcomes

The Pediatric Rehabilitation Program (PReP) is an intensive multidisciplinary pain treatment program offering children and adolescents physical therapy, occupational therapy, pain psychology (including individual, parent/caregiver, and family support), pain psychiatry, aquatic therapy, medical follow-up, acupuncture, and group therapies. Participants and their parents/caregivers are tracked weekly to monitor progress while in the program and following discharge utilizing the Pediatric Collaborative Health Outcomes Information Registry (Peds-CHOIR). Collecting such information may facilitate understanding of how youth with pain and their families progress during and after participation in an intensive rehabilitation model of treatment. Factors that predict functional gains and improvements in pain over time are explored. PReP participants are also involved in the “Capturing Pain: PhotoVoice” project, with additional Mindfulness programming planned for investigation in the coming year.

The Comfort Ability: A One-Day Workshop for Youth with Pain and Their Caregivers/Parents

Principal Investigator: Samantha Huestis, PhD, in collaboration with Rachael Coakley, PhD (Boston Children’s Boston)

The Comfort Ability is a supportive and interactive workshop designed to help youth ages 10 - 17 years old and their parents/caregivers learn strategies to better manage pain and improve daily functioning. General functioning, pain-specific processes and outcomes and behavioral health are assessed before and after participation in the one day program. The program is offered four times a year. Please email thecomfortability@stanford.edu for further details.

Adolescents and Young Adults with Chronic Pain: Transitioning from Pediatric to Adult Pain Services (AYA)

Principle Investigator: Amanda Feinstein, PhD

This mixed-methods study aims to learn about the characteristics, challenges, needs and expectations of adolescents and young adults (AYAs) with chronic pain and how to optimize their care. Investigators of this study seek to understand how to best support young adults as they are transitioned out of pediatric pain management care to adult pain management services.

Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE)

Principal Investigator: Samantha Huestis, PhD

CAPTIVATE is a biannual 9-week group therapy program for youth with chronic pain condition(s) and their parents/caregivers. Participants acquire coping skills while receiving support and learning from other families living with chronic pain. Youth are encouraged to engage in valued activities in the home, at school, and in the community. Caregivers are empowered to utilize behavior management strategies in the service of facilitating their child's functioning. Evidence-based treatments include Cognitive-Behavioral and Acceptance and Commitment Therapies, along with multi-family support. The program also incorporates physician guest speakers and sibling group(s) when appropriate, with past participants securing friendships that last long after the group's conclusion.

The Stanford Biobehavioral Pediatric Pain Lab's primary goal is to promote the health and well being of children and adolescents with chronic pain and their families. In line with this goal, research projects focus on biological, neurological, cognitive, affective, and social risk and resiliency factors of the pain experience. Projects include brain imaging, longitudinal clinical cohort, and treatment interventions studies.

Biobehavioral Pediatric Pain Lab Studies

Principal Investigator: Laura Simons, PhD

Please visit the BPP Lab website here to view current studies. Please email pedspainlab@stanford.edu for more information.

Treatment Pathways for Musculoskeletal Pain (TaP for MSK)

Principle Investigator: Ana Goya Arce, PhD

While there is extensive literature documenting racial, ethnic, and socioeconomic disparities in pain treatment in adults, less is known about whether similar disparities are present in the pediatric population. The purpose of this study is to utilize a retrospective review of the electronic medical record (EHR) to identify racial, ethnic, socioeconomic characteristics and clinical factors that impact the treatment recommendations, referrals to specialty care, and future health care utilization of children presenting to primary care with musculoskeletal pain concerns

Studying Intersecting Identities in Pain (SIIP)

Principle Investigator: Lauren Harrison, PhD

This study aims to address the major inadequacies in the assessment of sexual orientation and gender identity seen in research currently, as well as major gaps in our understanding of the experience of chronic pain in LGBTQ+ youth. This represents a critical first step in providing equitable and inclusive chronic pain care for LGBTQ+ youth. Investigators of this study hope to better understand the lived experience and psychosocial functioning of LGBTQ+ youth with chronic pain.

The Division of Pediatric Anesthesia within Stanford's School of Medicine is actively involved in scientific investigations conducted in pediatric pharmacology and drug development, advances in cardiac surgical and anesthetic techniques, advanced pain management techniques, acupuncture, and other areas of academic inquiry. Stanford Medicine anesthesiologists lecture and teach internationally, sharing their unique expertise with other medical centers around the world.

Healthcare Provider Behavior and Children’s Perioperative Distress

Principal Investigator: Brenda Golianu, MD

Funding: UC Irvine/NIH Prime

Given the need for an easily implemented strategy to improve post-operative outcomes by preventing high anxiety in children before surgery, this study aims to determine whether P-TIPS intervention is more effective than standard care for preventing anxiety before surgery among children undergoing anesthesia and surgery.

Long-term Follow-up of Adults Who Were Diagnosed with Complex Regional Pain Syndrome as Children

Principal Investigator: Becky Wong, MD

This project investigates the long-term effects of pediatric complex regional pain syndrome (diagnosis made when the patient was age 0-18 years old). Complex regional pain syndrome is a disease state which causes physical pain, sensory changes, and skin color changes of the affected body part. The projects seeks to identify any long-term problems with pain or physical function in the adults who had complex regional pain syndrome as children. Recognizing any long-term complications from this condition may help pediatric patients and their parents know what to expect with this diagnosis, and inform treatment plans.

Virtual Reality Therapy for Pediatric Chronic Pain

Principal Investigator: Brenda Golianu, MD

This study investigates the feasibility, acceptability, safety and effectiveness of Virtual Reality Therapy for pain and quality of life among pediatric pain patients. This therapy builds upon previous less technological therapies, such as “mirror box” therapy, which has been shown to decrease chronic pain. We would like to assess the effect to VR on pediatric patients with chronic pain.