This is a competitive renewal of K24HD060068. An estimated 20% to 40% of otherwise healthy children and adolescents suffer from chronic pain such as abdominal and musculoskeletal pain. Many of these children also experience significant sleep disturbances. Chronic pain and associated symptoms (such as sleep problems) results in a measurable decline in children's quality of life and produces stress and economic burden on parents and families. Increasingly, cognitive-behavioral therapies (CBT) are emerging as effective interventions for pediatric chronic pain. Because children and families face challenges accessing specialty services such as CBT for chronic pain, innovative technologies may be a solution for broadening access to care. The candidate's research activities during the prior period of K24 support focused on three areas: sleep-wake disturbances, behavioral interventions, and assessment of physical activity and function. Significant progress and achievements were made during the prior period of support in publications, new grants awarded, mentorship of fellows and junior faculty, career advancement, and academic leadership. The primary objectives of this renewal application for a Midcareer Investigator Award in Patient-Oriented Research are for the candidate to fully develop and evaluate innovative, cost-effective psychological treatments to decrease pain and sleep disturbances, and improve functioning in children and adolescents with chronic pain;to expand research knowledge of psychophysical pain assessment;and to teach new clinicians the skills necessary for developing innovative research in pediatric pain and supporting them in their transition to research independence. Over the next period of K24 support, the candidate will complete studies funded with current research support including a NIH/NICHD R01 grant to evaluate the efficacy of an internet-delivered behavioral intervention for pediatric chronic pain and disability (Project 1);and a NIH/NICHD R21 grant to develop and test the efficacy of a parental problem solving intervention designed to reduce distress in parent caregivers of youth with chronic pain (Project 2). New research proposed during the award is focused on evaluating the feasibility and preliminary efficacy of CBT for insomnia in youth with chronic pain and sleep disturbances (Project 3). Career objectives in mentoring beginning clinician investigators are to provide training in conducting assessment and intervention research using innovative technologies, to provide direct experience and training in writing grants and obtaining independent research funding, and to foster a career-long commitment to patient-oriented research. Formal didactic programs are available through several university programs including T32 postdoctoral training, a NIH KL2 program, and a Clinical research mentored scholars program. The University of Washington provides an ideal environment with a strong record of interdisciplinary patient-oriented pain research and collaborative science.

Public Health Relevance

Children and adolescents report severe chronic pain as frequently as adults, making chronic pain a major pediatric health issue with widespread social and economic costs. Unfortunately, access to effective evidence- based pain treatment is a significant barrier for many children. The candidate's research program is focused on developing innovative treatments for youth with chronic pain that are broadly accessible through the Internet, and which can target specific symptoms such as sleep problems. This research is expected to improve the current standard of care for children with chronic pain. The candidate seeks to train the next generation of patient-oriented researchers in this area.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Developmental Biology Subcommittee (CHHD)
Program Officer
Haverkos, Lynne
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Seattle Children's Hospital
United States
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Lifland, Brooke E; Mangione-Smith, Rita; Palermo, Tonya M et al. (2018) Agreement Between Parent Proxy Report and Child Self-Report of Pain Intensity and Health-Related Quality of Life After Surgery. Acad Pediatr 18:376-383
de la Vega, RocĂ­o; Groenewald, Cornelius; Bromberg, Maggie H et al. (2018) Chronic pain prevalence and associated factors in adolescents with and without physical disabilities. Dev Med Child Neurol 60:596-601
Palermo, Tonya M; Slack, Margaret; Zhou, Chuan et al. (2018) Waiting for a Pediatric Chronic Pain Clinic Evaluation: A Prospective Study Characterizing Waiting Times and Symptom Trajectories. J Pain :
Murray, Caitlin B; Palermo, Tonya M; Holmbeck, Grayson N (2018) A Multimethod, Case-Controlled Study of Sleep-Wake Disturbances in Adolescents With Spina Bifida. J Pediatr Psychol 43:601-612
Fisher, Emma; Law, Emily; Dudeney, Joanne et al. (2018) Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 9:CD003968
Clementi, Michelle A; Faraji, Pari; Poppert Cordts, Katrina et al. (2018) Parent Factors are Associated with Pain and Activity Limitations in Youth with Acute Musculoskeletal Pain: A Cohort Study. Clin J Pain :
Stone, Amanda L; Karlson, Cynthia W; Heathcote, Lauren C et al. (2018) Topical Review: Pain in Survivors of Pediatric Cancer: Applying a Prevention Framework. J Pediatr Psychol 43:237-242
Groenewald, Cornelius B; Rabbitts, Jennifer A; Hansen, Elizabeth E et al. (2018) Racial differences in opioid prescribing for children in the United States. Pain 159:2050-2057
Palermo, Tonya M; Dudeney, Joanne; Santanelli, James P et al. (2018) Feasibility and Acceptability of Internet-delivered Cognitive Behavioral Therapy for Chronic Pain in Adolescents With Sickle Cell Disease and Their Parents. J Pediatr Hematol Oncol 40:122-127
Rabbitts, Jennifer A; Aaron, Rachel V; Fisher, Emma et al. (2017) Long-Term Pain and Recovery After Major Pediatric Surgery: A Qualitative Study With Teens, Parents, and Perioperative Care Providers. J Pain 18:778-786

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