TeenMigraineConnection: Web-based self-management training for adolescents with m

DESCRIPTION (provided by applicant): Headache is a frequent health problem in children and adolescents (Winner and Rothner, 2001). The greatest impact on a child and caregiver is from migraine which can have a significant impact on disability (Hershey, et al., 2001), as well as quality of life (Powers, et al., 2004). For example, adolescents with migraine have lower grades at high school and are less likely to graduate from high school and attend college than adolescents without migraine (Rees and Sabia, 2009). Despite its prevalence and impact, pediatric migraine has received remarkably little attention and is commonly undiagnosed or misdiagnosed (Hershey and Winner, 2005). A number of health behavior changes can reduce migraine attack frequency, decrease the risk of migraine progression (Bigal, 2009) and significantly improve quality of life (Cottrell et al., 2007). Yet, little is available for this age group. We propose to develop an innovative, interactive, online pain self-management program for adolescents who suffer from migraines. This online health intervention, TeenMigraineConnection, will provide clinically reliable information about diagnosis, treatment, and management of migraine. Moreover, the use of Web 2.0 technology will enable the development of innovative features such as a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. On the caregiver side of the program, articles, lessons and tools will provide tailored information to help caregivers to reinforce adolescent self-management behaviors. Our review of websites suggests that no site currently offers this combination of empirically derived self-management features and cutting edge technologies. We believe the program will have a significant public health impact. With the overall total cost of migraine estimated at 13 to 15 billion dollars annually (Stewart, 2003), the program may improve quality of life for millions of adolescents while addressing risk factors for progression into adulthood, thus lowering this considerable cost. The content of this on-line health intervention will be developed and evaluated through the following specific aims: (1) Gather Input from Adolescents with Migraine, Caregivers, and Migraine Experts about Design and Content of the Website and the Mobile Application; (2) Develop Content, Design, and Technology Development Plans; (3) Develop Rapid Flash Prototype of Website and Paper-Prototyping of Mobile Application; (4) Conduct Usability and Acceptance Tests with Adolescent Patients and Caregivers, and (5) Conduct Acceptance Tests with Experts. PUBLIC HEALTH RELEVANCE: We propose to develop an interactive, online pain self-management program for adolescents with migraine and their caregivers. The program will include innovative features, including a headache diary that can be accessed through a mobile device to facilitate real-time updates; motivational, tailored information to increase self-efficacy for self-management behaviors, as well as video-based testimonies and social networking to enhance social support. Overall, TeenMigraineConnection represents a significant innovation that has the potential to have a dramatic public health impact by improving quality of life for millions of adolescents while addressing risk factors for progression into adulthood.