Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis
BackgroundEngagement predicts benefits from self-managed treatments. However, engagement is an important concern in digital interventions, with over 50% of patients being nonadherent to interventions in chronic conditions such as chronic pain. Little is known about the indivi...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-03-01
|
| Series: | JMIR Pediatrics and Parenting |
| Online Access: | https://pediatrics.jmir.org/2023/1/e42399 |
| _version_ | 1797734403412066304 |
|---|---|
| author | Rocio de la Vega Tonya M Palermo |
| author_facet | Rocio de la Vega Tonya M Palermo |
| author_sort | Rocio de la Vega |
| collection | DOAJ |
| description |
BackgroundEngagement predicts benefits from self-managed treatments. However, engagement is an important concern in digital interventions, with over 50% of patients being nonadherent to interventions in chronic conditions such as chronic pain. Little is known about the individual characteristics that contribute to engagement with a digital self-management treatment.
ObjectiveThis study tested the mediating role of treatment perceptions (difficulty and helpfulness) in the association between individual baseline characteristics (treatment expectancies and readiness to change) and treatment engagement (online and offline) with a digital psychological intervention for adolescents with chronic pain.
MethodsA secondary data analysis of a single-arm trial of Web-based Management of Adolescent Pain, a self-guided internet intervention developed for the management of chronic pain in adolescents, was conducted. Survey data were collected at baseline (T1), midtreatment (ie, 4 weeks after the treatment started; T2), and post treatment (T3). Online engagement was assessed using back-end information on the number of days adolescents accessed the treatment website, while the offline engagement was assessed with the reported frequency of use of skills (ie, pain management strategies) learned at the end of the treatment. Four parallel multiple mediator linear regression models, using ordinary least square regression incorporating the variables were tested.
ResultsIn total, 85 adolescents with chronic pain (12-17 years old, 77% female) participated. Several mediation models were significant in predicting online engagement. A significant indirect effect was found for the path expectancies–helpfulness–online engagement (effect 0.125; SE 0.098; 95% CI 0.013-0.389) and for the path precontemplation–helpfulness–online engagement (effect −1.027; SE 0.650; 95% CI −2.518 to −0.054). Fourteen percent of the variance of online engagement was explained by the model including expectancies as a predictor (F3=3.521; P<.05), whereas 15% was explained by the model where readiness to change was the predictor (F3=3.934; P<.05). Offline engagement was partially explained in the model including readiness to change as the predictor but with marginal significance (F3=2.719; R2=0.111; P=.05).
ConclusionsTreatment perception, specifically, perceived helpfulness, was a mediator of the pathway between both treatment expectancies and readiness to change and online engagement with a digital psychological intervention for chronic pain. Assessing these variables at baseline and midtreatment may help to determine the risk of nonadherence. Further work is needed to confirm these mediation pathways in larger samples.
Trial RegistrationClinicalTrials.gov NCT04043962; https://clinicaltrials.gov/ct2/show/NCT04043962 |
| first_indexed | 2024-03-12T12:43:49Z |
| format | Article |
| id | doaj.art-cf41cc53f70e4d709b4904c489253732 |
| institution | Directory Open Access Journal |
| issn | 2561-6722 |
| language | English |
| last_indexed | 2024-03-12T12:43:49Z |
| publishDate | 2023-03-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Pediatrics and Parenting |
| spelling | doaj.art-cf41cc53f70e4d709b4904c4892537322023-08-28T23:42:18ZengJMIR PublicationsJMIR Pediatrics and Parenting2561-67222023-03-016e4239910.2196/42399Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data AnalysisRocio de la Vegahttps://orcid.org/0000-0002-2517-6948Tonya M Palermohttps://orcid.org/0000-0001-6036-6715 BackgroundEngagement predicts benefits from self-managed treatments. However, engagement is an important concern in digital interventions, with over 50% of patients being nonadherent to interventions in chronic conditions such as chronic pain. Little is known about the individual characteristics that contribute to engagement with a digital self-management treatment. ObjectiveThis study tested the mediating role of treatment perceptions (difficulty and helpfulness) in the association between individual baseline characteristics (treatment expectancies and readiness to change) and treatment engagement (online and offline) with a digital psychological intervention for adolescents with chronic pain. MethodsA secondary data analysis of a single-arm trial of Web-based Management of Adolescent Pain, a self-guided internet intervention developed for the management of chronic pain in adolescents, was conducted. Survey data were collected at baseline (T1), midtreatment (ie, 4 weeks after the treatment started; T2), and post treatment (T3). Online engagement was assessed using back-end information on the number of days adolescents accessed the treatment website, while the offline engagement was assessed with the reported frequency of use of skills (ie, pain management strategies) learned at the end of the treatment. Four parallel multiple mediator linear regression models, using ordinary least square regression incorporating the variables were tested. ResultsIn total, 85 adolescents with chronic pain (12-17 years old, 77% female) participated. Several mediation models were significant in predicting online engagement. A significant indirect effect was found for the path expectancies–helpfulness–online engagement (effect 0.125; SE 0.098; 95% CI 0.013-0.389) and for the path precontemplation–helpfulness–online engagement (effect −1.027; SE 0.650; 95% CI −2.518 to −0.054). Fourteen percent of the variance of online engagement was explained by the model including expectancies as a predictor (F3=3.521; P<.05), whereas 15% was explained by the model where readiness to change was the predictor (F3=3.934; P<.05). Offline engagement was partially explained in the model including readiness to change as the predictor but with marginal significance (F3=2.719; R2=0.111; P=.05). ConclusionsTreatment perception, specifically, perceived helpfulness, was a mediator of the pathway between both treatment expectancies and readiness to change and online engagement with a digital psychological intervention for chronic pain. Assessing these variables at baseline and midtreatment may help to determine the risk of nonadherence. Further work is needed to confirm these mediation pathways in larger samples. Trial RegistrationClinicalTrials.gov NCT04043962; https://clinicaltrials.gov/ct2/show/NCT04043962https://pediatrics.jmir.org/2023/1/e42399 |
| spellingShingle | Rocio de la Vega Tonya M Palermo Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis JMIR Pediatrics and Parenting |
| title | Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis |
| title_full | Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis |
| title_fullStr | Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis |
| title_full_unstemmed | Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis |
| title_short | Mediating Role of Treatment Perceptions in the Relationship Between Individual Characteristics and Engagement With a Digital Psychological Intervention for Pediatric Chronic Pain: Secondary Data Analysis |
| title_sort | mediating role of treatment perceptions in the relationship between individual characteristics and engagement with a digital psychological intervention for pediatric chronic pain secondary data analysis |
| url | https://pediatrics.jmir.org/2023/1/e42399 |
| work_keys_str_mv | AT rociodelavega mediatingroleoftreatmentperceptionsintherelationshipbetweenindividualcharacteristicsandengagementwithadigitalpsychologicalinterventionforpediatricchronicpainsecondarydataanalysis AT tonyampalermo mediatingroleoftreatmentperceptionsintherelationshipbetweenindividualcharacteristicsandengagementwithadigitalpsychologicalinterventionforpediatricchronicpainsecondarydataanalysis |