Co-Adaptation of an Digital Pain Management Program for Canadian Veterans (ADOPTCanVets)

September 11, 2026 updated by: University Health Network, Toronto

Co-Adaptation of a Digital Chronic Pain Self-Management Program for Canadian Veterans

The goal of this study is to gather feedback from Canadian Veterans living with chronic pain, and clinicians serving Canadian Veterans, on an existing digital psychology program for self-management of chronic pain delivered through the Manage My Pain app. This feedback will be used to adapt the program for the needs and experiences of Canadian Veterans.

The main questions it aims to answer are:

  • How acceptable, feasible, and engaging is the existing digital psychology program for Canadian Veterans living with chronic pain?
  • What changes are needed to make the program more relevant and appropriate for Canadian Veterans living with chronic pain?

Participants will:

  • Use the self-guided digital psychology program over a two-week period and complete questionnaires about the program's acceptability and feasibility. Veteran participants will also complete questionnaires about their pain and pain history.
  • Take part in a 30- to 45-minute virtual interview to provide feedback about the program and recommendations for its adaptation.

The study does not include a comparison group.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Chronic pain affects approximately 30% to 50% of Canadian Veterans, many of whom experience barriers to accessing interprofessional pain services, particularly when transitioning from military to civilian healthcare. Digital health interventions may help address gaps in care by providing accessible, evidence-based self-management support while Veterans await services or alongside their existing clinical care. However, these interventions must be adapted to reflect Veterans' needs and experiences, including military culture, values and language, pain- and mental health-related stigma, experiences of trauma, and challenges navigating the civilian healthcare system. Acceptance and Commitment Therapy (ACT) is an evidence-based psychological intervention that can improve pain-related functioning, pain acceptance, and quality of life among people living with chronic pain, including Veterans. The current study will support the co-adaptation of an existing self-guided digital ACT intervention delivered through the Manage My Pain mobile health platform. Canadian Veterans living with chronic pain and clinicians experienced in providing evidence-based pain psychology interventions to Veterans will use the existing program and provide feedback through questionnaires and semi-structured interviews. Their feedback will inform modifications to the program's content, language, format, and delivery to create Advancing Online Pain Psychology Tools for Canadian Veterans (ADOPT-CanVets). The adapted program will subsequently be ready for evaluation in a feasibility trial. Once evaluated, ADOPT-CanVets may provide a scalable approach to increasing Canadian Veterans' access to evidence-based psychological support for chronic pain.

Study Type

Observational

Enrollment (Estimated)

22

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5G 2N2
        • Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network
        • Contact:
        • Contact:
        • Principal Investigator:
          • Hance Clarke, MD, PhD

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population will include two groups recruited in Canada: adult Canadian Armed Forces Veterans living with chronic pain for at least 3 months and healthcare providers experienced in delivering evidence-based pain psychology interventions to Canadian Veterans. Veterans will be recruited through Canadian Veteran organizations, social media, and existing lists of individuals who have expressed interest in research. Clinicians will be recruited through professional networks using snowball sampling.

Description

Inclusion Criteria (Veterans):

  • Veterans of the Canadian Armed Forces who report having chronic pain (pain for 3 months or longer).
  • Have access to a device that can connect to the Internet.

Inclusion Criteria (Clinicians):

  • Healthcare providers actively practicing in Canada.
  • Healthcare providers delivering evidence-based psychology interventions to Canadian Veterans (e.g., clinical psychologists, psychotherapists, social workers, counselors)
  • Have access to a device that can connect to the Internet.

Exclusion Criteria (Veterans):

  • Individuals with a known history of serious mental illness (e.g., psychosis and/or active mania).
  • Individuals who have limited comprehension of English or comprehension deficits due to dementia.
  • Individuals with physical or cognitive impairments that prevent effective engagement with an online intervention (e.g., serious uncorrected visual or hearing impairment).

Exclusion Criteria (Clinicians):

- Healthcare providers who have limited comprehension of English

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Canadian Veterans
Adult Canadian Veterans living with chronic pain for at least 3 months. Participants will use the existing self-guided digital Acceptance and Commitment Therapy program through the Manage My Pain app over 2 weeks. They will then complete questionnaires assessing program acceptability, and feasibility, pain and pain history, as well as a semi-structured interview about their experiences with the program and recommended adaptations.
Other: Self-Guided Digital Acceptance and Commitment Therapy Program
A self-guided digital psychology program based on Acceptance and Commitment Therapy and delivered through the Manage My Pain app. The program includes interactive psychoeducation about chronic pain and Acceptance and Commitment Therapy, recognition of pain-related avoidance, clarification of personal values, identification of meaningful actions, strategies for making room for difficult experiences, and flexible persistence in meaningful activities.
Clinicians Serving Canadian Veterans
Canadian healthcare providers experienced in delivering evidence-based pain psychology interventions to Veterans. Participants will use the existing self-guided digital Acceptance and Commitment Therapy program through the Manage My Pain app over 2 weeks. They will then complete questionnaires assessing program acceptability and feasibility and participate in a semi-structured interview about recommended adaptations for Canadian Veterans.
Other: Self-Guided Digital Acceptance and Commitment Therapy Program
A self-guided digital psychology program based on Acceptance and Commitment Therapy and delivered through the Manage My Pain app. The program includes interactive psychoeducation about chronic pain and Acceptance and Commitment Therapy, recognition of pain-related avoidance, clarification of personal values, identification of meaningful actions, strategies for making room for difficult experiences, and flexible persistence in meaningful activities.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Program Usage and Engagement as assessed by Manage My Pain Platform Usage Analytics
Time Frame: Participants will have their usage analytics tracked from access to the self-guided program to completion of the program, an average of 2 weeks.
Manage My Pain platform usage analytics will be used to assess engagement with the self-guided digital psychology program. Engagement metrics will include module access dates, time spent in each module, and the total number of modules completed by each participant. A greater number of completed modules will indicate greater program engagement.
Participants will have their usage analytics tracked from access to the self-guided program to completion of the program, an average of 2 weeks.
Program Acceptability as assessed by the Treatment Evaluation Inventory-Short Form
Time Frame: Participants will be sent a link to fill out the measure within 1 week of completing the program.
Program acceptability will be assessed using the 9-item Treatment Evaluation Inventory-Short Form (TEI-SF). Items are rated on a 5-point scale and summed to produce a total score ranging from 9 to 45. Higher scores indicate greater acceptability.
Participants will be sent a link to fill out the measure within 1 week of completing the program.
Program Feasibility as assessed by the Feasibility Survey
Time Frame: Participants will be sent a link to fill out the measure within 1 week of completing the program.
Participants' perceptions of program feasibility, acceptability, usability, and connection to the program will be assessed using a 13-item survey. Items are rated on a 7-point scale and may be examined individually or averaged to produce a mean score ranging from 1 to 7. The survey also includes an open-ended feedback question.
Participants will be sent a link to fill out the measure within 1 week of completing the program.
Retrospective Semi-structured Interview
Time Frame: Participants will be sent an invitation for an interview within 1 week after completing the survey questions.
A 30- to 45-minute semi-structured interview will explore participants' experiences with the existing program and their recommendations for adapting its content, language, format, and delivery for Canadian Veterans.
Participants will be sent an invitation for an interview within 1 week after completing the survey questions.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity as assessed by the PROMIS Pain Intensity-Short Form 3a - Veteran Participants Only
Time Frame: Participants will be sent a link to fill out the measure within 1 week of completing the program.
Pain intensity among Veteran participants will be assessed using the 3-item Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity-Short Form 3a. The measure assesses pain at its worst, average pain, and current pain. Responses will be scored according to PROMIS scoring guidelines, with higher scores indicating greater pain intensity.
Participants will be sent a link to fill out the measure within 1 week of completing the program.
Pain Interference as assessed by the PROMIS Pain Interference-Short Form 4a - Veteran Participants Only
Time Frame: Participants will be sent a link to fill out the measure within 1 week of completing the program.
Pain interference among Veteran participants will be assessed using the 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference-Short Form 4a. The measure assesses pain interference in daily activities and social interactions. Responses will be scored according to PROMIS scoring guidelines, with higher scores indicating greater pain interference.
Participants will be sent a link to fill out the measure within 1 week of completing the program.
Chronic Pain History as assessed by the Chronic Pain History Questionnaire - Veteran Participants Only
Time Frame: Participants will be sent a link to fill out the measure within 1 week of completing the program.
Chronic pain history among Veteran participants will be characterized using a 4-item self-report questionnaire assessing the duration and frequency of ongoing pain and the type of pain condition experienced. Responses will be summarized descriptively.
Participants will be sent a link to fill out the measure within 1 week of completing the program.

Collaborators and Investigators

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

Sponsor

University Health Network, Toronto

Collaborators

Chronic Pain Centre of Excellence for Canadian Veterans

Investigators

  • Principal Investigator: Hance Clarke, MD, PhD, University Health Network, Toronto

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

September 1, 2026

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 30, 2027

Study Registration Dates

First Submitted

August 26, 2026

First Submitted That Met QC Criteria

September 11, 2026

First Posted (Actual)

September 14, 2026

Study Record Updates

Last Update Posted (Actual)

September 14, 2026

Last Update Submitted That Met QC Criteria

September 11, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 26-5032

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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