Efficacy research demonstrates that written self-disclosure (WSD) improves physiology, health status, and health care utilization in healthy young people (> age 14) and in adults with one of two chronic diseases. Our team has further shown that WSD may reduce service utilization when implemented in adult primary health care as well as specialty health care for young people (> age 14) with a chronic disease. We now propose a pilot study to evaluate: (1) the effectiveness of WSD on health status of youth ages 12-18 with functional recurrent abdominal pain (RAP); (2) whether effectiveness of WSD is similar for younger (12-14) and older (15-18) youth with functional RAP; and (3) the feasibility and acceptability of WSD when extended to the pediatric health care setting. We will implement a RCT design to compare health status in 140 youths (ages 12-18) with functional RAP assigned either to standard medical care (SMC) or WSD provided in the health care setting in addition to SMC. Health status will be measured at Baseline and 3-and 6-months thereafter. Primary measures of health status are symptom severity and episode frequency, consistent with the definition of RAP. Secondary measures of health are functional health, psychological distress, health-related quality of life, and health care utilization. Total use and diagnostic tests will index health care utilization, collected for the 6-mos prior to and following Baseline. Mixed model ANOVA or MANOVA will be used to test directional hypotheses corresponding to the specific aims. Consistent with the indicated Program Announcement, this project translates a promising intervention to the clinical setting and provides preliminary effectiveness data that can support a future multi-center research grant application.
| Wallander, Jan L; Madan-Swain, Avi; Klapow, Josh et al. (2011) A randomised controlled trial of written self-disclosure for functional recurrent abdominal pain in youth. Psychol Health 26:433-47 |
