The Use of a Comfort Tote to Improve Recovery in Pediatric and Adolescent Patients After Surgery

June 2, 2026 updated by: Mirna Giordano, Columbia University

The Use of the Comfort Tote Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: a Randomized Controlled Trial Pilot Study

The goal of this clinical trial is to learn if the use of Comfort Tote can treat pain and anxiety in adolescents with idiopathic scoliosis undergoing posterior spinal fusion. The study aims to answer two questions:

  1. To characterize the effectiveness and determine the impact of integrative therapy interventions of the Comfort Tote use in reducing self-reported pain, anxiety, and stress among pediatric patients with AIS undergoing PSF. By comparing self-reported pain, anxiety, and stress scores, as well as documented Morphine Milligram Equivalents (MMEs) and Numeric Rating Scale (NRS) pain scores, between patients using non-therapeutic and therapeutic Comfort Totes.
  2. To evaluate the impact of an educational video on the use of the Comfort Tote. This will assess whether the inclusion of instructional content enhances understanding and application of the Comfort Tote, thereby improving patient outcomes in pain management, anxiety reduction, and overall satisfaction with care. It is hypothesized that the therapeutic Comfort Tote intervention with the educational video will provide the highest patient satisfaction and greater tote usage, with decreased patient pain, stress, and anxiety levels. The findings from this pilot study will provide crucial insights into establishing a new standard of care for pediatric patients undergoing PSF and potentially provide baseline data for use in larger, multicenter randomized controlled trials.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

The single-blind randomized controlled trial pilot study will include 50 adolescent participants aged 12 to 21, evenly distributed between the two study arms: a non-therapeutic modified Comfort Tote with written instructions and a therapeutic Comfort Tote with written instructions and an educational video. The RCT will be a single-blind study, with patients blinded to the intervention they receive. All totes will be available in English and Spanish, and patients will receive them during the pre-operative visit with the orthopedics team post-randomization. The non-therapeutic Comfort Tote will contain the following items: journal, coloring book, coloring pencils/markers, stuffed animal, non-scented hand lotion, earplugs, sleep eye mask, and fidget spinner/pop-it. This Tote will come with written instructions. The therapeutic Comfort Tote will contain the following items: aromatherapy kit including two essential oils: Balance and Clear, a firm and soft stress ball, five acupressure points including a plasticized map, Mindful Breathing, ImaginAction, EFT/Tapping, and a journal with prompts and coloring pencils included. The patients will also receive written instructions and watch a video outlining the contents of the tote and how to use each item.

Both prospective and retrospective methods will be used. A survey will be delivered at the final, postoperative in-hospital appointment between patients and their surgical team. The survey will evaluate their experience with the Comfort Tote. Primary outcomes include the impact of each Comfort Tote item on post-operative pain, stress, and anxiety scores. These will be assessed through a Qualtrics survey using a scale ranging from "did not help at all" to "helped a little" to "helped a lot". Every patient will be linked to a respective page to receive a Qualtrics survey, and this link will be texted/emailed to them. Caregivers will also receive a Qualtrics survey about their experiences with the Comfort Tote, sent via text or email. General patient pain scores will also be evaluated using measures in EPIC, including the Numeric Rating Scale (NRS).

Secondary outcomes include tote item usage, length of hospital stay (LOS), Intensive Care Unit (ICU) LOS, total direct costs (TDC), morphine milligram equivalents (MME) administered during the hospital stay, opioid prescriptions at discharge, surgical site infections, readmissions or unanticipated return to clinic, and mobility scores through the AM PAC mobility score determined by physical therapy. Tote usage indicates results from patients recording which tote components they used, collected through a post-operative Qualtrics survey. Secondary outcomes will also include whether or not patients took Gabapentin, and patients will receive a calendar with instructions upon discharge to document opioid use at home. Caregivers will also be surveyed at the final postoperative in-hospital appointment to understand their experiences with the Comfort Tote.

Aim 1: Evaluate whether the Comfort Tote intervention leads to greater reductions in self-reported pain, stress, and anxiety among patients diagnosed with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF).

Aim 2: Assess the effect of the therapeutic Comfort Tote on hospital resource utilization - specifically length of stay, ICU days, and direct costs - as well as opioid exposure, including in-hospital morphine milligram equivalents and opioid prescriptions at discharge. Additionally, this study will examine clinical outcomes, including surgical-site infections, unanticipated readmissions or clinic visits, and discharge mobility, using AM-PAC mobility scores.

Aim 3: Assess patient caregivers' experiences with and perceptions of the Comfort Tote's usefulness using data collected via a brief structured survey.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
50

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients of all genders, racial, and ethnic groups aged between 10 and 21 that have had been diagnosed with AIS requiring surgical correction with PSF.
  • Patients must be scheduled to undergo PSF at Morgan Stanley Children's Hospital of NYP.
  • The patients and their parent(s)/legal guardian(s) must also provide informed consent, for those under 18 years old.
  • The patient population will include mental health conditions such as anxiety and/or depression and all surgery levels.

Exclusion Criteria:

  • Patients who have had growing rods and revisions, those who have local or systemic infections, those with anemia, cardiovascular diseases, or osteoporosis, and patients with severe medical comorbidities such as neurological or developmental condition that precludes engagement with the Comfort Tote
  • Patients with two or more chronic conditions (excluding AIS)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Therapeutic Comfort Tote
Participants will be randomly assigned to receive the Therapeutic Comfort Tote.
Other: The Therapeutic Comfort Tote
The therapeutic Comfort Tote will contain the following items: aromatherapy kit including two essential oils: Balance and Clear, a firm and soft stress ball, five acupressure points including a plasticized map, Mindful Breathing, ImaginAction, EFT/Tapping, and a journal with prompts and coloring pencils included. The patients will also receive written instructions and watch an educational video outlining the contents of the tote and how to use each item.
Placebo Comparator: Modified Comfort Tote
Participants will be randomly assigned to receive the Modified Comfort Tote.
Other: The Modified Comfort Tote
The non-therapeutic Comfort Tote will contain the following items: journal, coloring book, coloring pencils/markers, stuffed animal, non-scented hand lotion, earplugs, sleep eye mask, and fidget spinner/pop-it. This Tote will come with written instructions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Primary Outcome: Pain
Time Frame: From surgery date up to four weeks after surgery
Impact of each item used in the Comfort Tote on post-operative pain. This will be assessed through a Qualtrics survey across a scale ranging from did not help at all, helped a little, or helped a lot. The number of participants who responded to each of the three options will be reported. Every patient will be linked to a respective page to receive a Qualtrics survey, and this link will be texted/emailed to them.
From surgery date up to four weeks after surgery
Primary Outcome: Stress
Time Frame: From surgery date up to four weeks after surgery
Impact of each item used in the Comfort Tote on post-operative stress. This will be assessed through a Qualtrics survey across a scale ranging from did not help at all, helped a little, or helped a lot. The number of participants who responded to each of the three options will be reported. Every patient will be linked to a respective page to receive a Qualtrics survey, and this link will be texted/emailed to them.
From surgery date up to four weeks after surgery
Primary Outcome: Anxiety
Time Frame: From surgery date up to four weeks after surgery
Impact of each item used in the Comfort Tote on post-operative anxiety. This will be assessed through a Qualtrics survey across a scale ranging from did not help at all, helped a little, or helped a lot. The number of participants who responded to each of three options will be reported. Every patient will be linked to a respective page to receive a Qualtrics survey, and this link will be texted/emailed to them.
From surgery date up to four weeks after surgery
Primary Outcome: Patient Pain scores
Time Frame: From surgery date up to four weeks after surgery
General patient pain scores will be evaluated through measures in EPIC, including Numeric Rating Scale (NRS) pain scores (0-10, 0 being no pain, and 10 being the most severe pain experienced).
From surgery date up to four weeks after surgery
Primary Outcome: Caregiver's impression
Time Frame: From surgery date up to four weeks after surgery
Caregivers will also receive a Qualtrics survey to understand their experiences with the Comfort Tote, which will be texted/emailed to them. The scale will include a range of responses from did not help, to help a little, to help a lot. The number of participants who responded to each of the three options will be reported.
From surgery date up to four weeks after surgery

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Secondary Outcomes: Tote items usage
Time Frame: From surgery date up to four weeks after surgery
Secondary outcomes include tote item usage. Tote usage indicates results from patients recording which tote components they used, collected through a post-operative Qualtrics survey. The patients will register if they used the item even once - yes, no, or not sure.
From surgery date up to four weeks after surgery
Length of stay
Time Frame: From surgery date until discharge date, assessed up to four weeks after surgery
Secondary outcomes include length of hospital stay (LOS) in days.
From surgery date until discharge date, assessed up to four weeks after surgery
ICU LOS
Time Frame: From surgery date until discharge date, assessed up to four weeks after surgery
Secondary outcomes include Intensive Care Unit (ICU) LOS in days.
From surgery date until discharge date, assessed up to four weeks after surgery
Total direct cost
Time Frame: From surgery date until discharge date, assessed up to four weeks after surgery
Secondary outcomes include total direct costs (TDC) in dollars.
From surgery date until discharge date, assessed up to four weeks after surgery
MME use during hospital admission
Time Frame: From surgery date until discharge date, assessed up to four weeks after surgery
Secondary outcomes include morphine milligram equivalents (MME) administered during the hospital stay from the EPIC-recorded pain team's notes.
From surgery date until discharge date, assessed up to four weeks after surgery
Opioid prescriptions at discharge
Time Frame: From discharge from hospital until up to four weeks after surgery
Secondary outcomes include opioid prescriptions at discharge in total milligrams and milligrams per dose.
From discharge from hospital until up to four weeks after surgery
Surgical site infections
Time Frame: From surgery date until up to four weeks after surgery
Secondary outcomes include surgical site infections.
From surgery date until up to four weeks after surgery
Readmissions
Time Frame: Assessed up to 4 weeks after surgery
Secondary outcomes include readmissions, defined as hospital admissions within 30 days of discharge.
Assessed up to 4 weeks after surgery
Unanticipated return to clinic
Time Frame: Assessed up to 4 weeks after surgery
Secondary outcomes include unanticipated return to clinic.
Assessed up to 4 weeks after surgery
Mobility Scores
Time Frame: Assessed up to 4 weeks after surgery
Secondary outcomes include mobility scores via AM PAC mobility scores assigned by physical therapy. Includes six possible scores: 1-Rolling over in bed 2- Sitting up from lying down 3- Sitting down and standing up from a chair 4- Moving from sitting to standing (transfers)5- Walking 6- Climbing stairs
Assessed up to 4 weeks after surgery
Gabapentin use
Time Frame: From surgery date until up to four weeks after surgery
Secondary outcomes include whether or not patients took Gabapentin.
From surgery date until up to four weeks after surgery
Postoperative opioid use at home
Time Frame: From discharge until up to four weeks after surgery
Secondary outcomes include postoperative opioid use via a calendar with instructions upon discharge to document opioid use at home.
From discharge until up to four weeks after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Columbia University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 15, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 15, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
June 30, 2028

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 2, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 2, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
June 8, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 8, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 2, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • ACYY0676

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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