The Specific Aims of this Midcareer Investigator Award application are to 1) successfully implement an ongoing randomized clinical trial in juvenile fibromyalgia 2) perform a prospective longitudinal study to determine long term prognosis of pediatric patients with juvenile fibromyalgia, and 3) use the candidate's ongoing and planned studies in the Pediatric Pain Research Program to train post-doctoral fellows and junior faculty in pediatric pain research. The Candidate's programmatic line of research focuses on physical and psychosocial functioning of children and adolescents with chronic pain, with an emphasis on juvenile fibromyalgia syndrome - a very poorly understood chronic pain condition for which there is no evidence- based treatment. The Research Plan includes two projects: a NIAMS funded multi-site randomized clinical trial (ROl) to test the efficacy of cognitive behavioral treatment for children and adolescents with juvenile fibromyalgia, and a longitudinal study of outcomes in juvenile fibromyalgia. The candidate's future plans are to use findings from current projects to develop the most effective treatments for juvenile fibromyalgia and other pediatric pain conditions. The Mentoring Plan is to train future clinical investigators in the field of clinical interventions and outcomes research in pediatric chronic pain. The candidate's plan consists of 1) individualized mentoring of postdoctoral fellows supported by two currently funded clinical trials (Treatment of Juvenile Fibromyalgia, and Chronic Pediatric Headaches), the proposed longitudinal study in juvenile fibromyalgia, and other ongoing clinical and translational research studies in pediatric pain 2) mentoring of fellows to develop their own independent research proposals and 3) participation of fellows in established didactic programs on manuscript and grant writing, clinical research methodology and responsible conduct of human research. Cincinnati Children's provides an ideal setting for this award because of the strong institutional support for patient-oriented research, presence of an award winning chronic pain program, support from the Divisional Data Core for methodological and data management issues, and a commitment of the institution to "change the outcomes" for pediatric patients.

Public Health Relevance

(See Instructions): This study meets the public health goal of better understanding and treating a poorly understood chronic pain condition of childhood (juvenile fibromyalgia) along with the goal of training the next generation of clinician-scientists in clinical and translational research in pediatric pain.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Serrate-Sztein, Susana
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Cincinnati Children's Hospital Medical Center
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Jones, Jordan T; Cunningham, Natoshia; Kashikar-Zuck, SusmitA et al. (2016) Pain, Fatigue, and Psychological Impact on Health-Related Quality of Life in Childhood-Onset Lupus. Arthritis Care Res (Hoboken) 68:73-80
Kashikar-Zuck, Susmita; Tran, Susan T; Barnett, Kimberly et al. (2016) A Qualitative Examination of a New Combined Cognitive-Behavioral and Neuromuscular Training Intervention for Juvenile Fibromyalgia. Clin J Pain 32:70-81
Kashikar-Zuck, Susmita; King, Christopher; Ting, Tracy V et al. (2016) Juvenile Fibromyalgia: Different from the Adult Chronic Pain Syndrome? Curr Rheumatol Rep 18:19
Tran, Susan T; Guite, Jessica W; Pantaleao, Ashley et al. (2016) Preliminary outcomes of a cross-site cognitive-behavioral and neuromuscular integrative training intervention for juvenile fibromyalgia. Arthritis Care Res (Hoboken) :
Cunningham, Natoshia Raishevich; Jagpal, Anjana; Peugh, James et al. (2016) Risk Categorization Predicts Disability in Pain-associated Functional Gastrointestinal Disorders (FGIDs) After 6 Months. J Pediatr Gastroenterol Nutr :
Cunningham, Natoshia Raishevich; Jagpal, Anjana; Tran, Susan T et al. (2016) Anxiety Adversely Impacts Response to Cognitive Behavioral Therapy in Children with Chronic Pain. J Pediatr 171:227-33
Nelson, Sarah M; Cunningham, Natoshia Raishevich; Kashikar-Zuck, Susmita (2016) A Conceptual Framework for Understanding the Role of Adverse Childhood Experiences in Pediatric Chronic Pain. Clin J Pain :
Tran, Susan T; Thomas, Staci; DiCesare, Christopher et al. (2016) A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia. Pediatr Rheumatol Online J 14:43
Cunningham, Natoshia Raishevich; Tran, Susan T; Lynch-Jordan, Anne M et al. (2015) Psychiatric Disorders in Young Adults Diagnosed with Juvenile Fibromyalgia in Adolescence. J Rheumatol 42:2427-33
Cunningham, Natoshia R; Cohen, Mitchell B; Farrell, Michael K et al. (2015) Concordant parent-child reports of anxiety predict impairment in youth with functional abdominal pain. J Pediatr Gastroenterol Nutr 60:312-7

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