Co-Adaptation of an Digital Pain Management Program for Canadian Veterans (ADOPTCanVets)
2026年9月15日 更新者：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.
研究概览
详细说明
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.
研究类型
观察性的
注册 (估计的)
22
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习联系方式
- 姓名：Hance A Clarke, MD, PhD
- 电话号码：4251 416-340-4800
- 邮箱：hance.clarke@uhn.ca
研究联系人备份
- 姓名：Peter M Slepian, PhD
- 邮箱：maxwell.slepian@uhn.ca
学习地点
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Ontario
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Toronto、Ontario、加拿大、M5G 2N2
- 招聘中
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network
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接触：
- Deep Grewal
- 邮箱：deep.grewal@uhn.ca
-
接触：
- Hance Clarke, MD, PhD
- 电话号码：4251 416-340-4800
- 邮箱：hance.clarke@uhn.ca
-
首席研究员：
- Hance Clarke, MD, PhD
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
不
取样方法
非概率样本
研究人群
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.
描述
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
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
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.
|
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.
|
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.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Program Usage and Engagement as assessed by Manage My Pain Platform Usage Analytics
大体时间：Participants will have their usage analytics tracked from access to the self-guided program to completion of the program, an average of 2 weeks.
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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.
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Program Acceptability as assessed by the Treatment Evaluation Inventory-Short Form
大体时间：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.
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Participants will be sent a link to fill out the measure within 1 week of completing the program.
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Program Feasibility as assessed by the Feasibility Survey
大体时间：Participants will be sent a link to fill out the measure within 1 week of completing the program.
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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.
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Participants will be sent a link to fill out the measure within 1 week of completing the program.
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Retrospective Semi-structured Interview
大体时间：Participants will be sent an invitation for an interview within 1 week after completing the survey questions.
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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.
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Participants will be sent an invitation for an interview within 1 week after completing the survey questions.
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Pain Intensity as assessed by the PROMIS Pain Intensity-Short Form 3a - Veteran Participants Only
大体时间：Participants will be sent a link to fill out the measure within 1 week of completing the program.
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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.
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Participants will be sent a link to fill out the measure within 1 week of completing the program.
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Pain Interference as assessed by the PROMIS Pain Interference-Short Form 4a - Veteran Participants Only
大体时间：Participants will be sent a link to fill out the measure within 1 week of completing the program.
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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.
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Participants will be sent a link to fill out the measure within 1 week of completing the program.
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Chronic Pain History as assessed by the Chronic Pain History Questionnaire - Veteran Participants Only
大体时间：Participants will be sent a link to fill out the measure within 1 week of completing the program.
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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.
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Participants will be sent a link to fill out the measure within 1 week of completing the program.
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Hance Clarke, MD, PhD、University Health Network, Toronto
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med. 2022 Jan;292:114523. doi: 10.1016/j.socscimed.2021.114523. Epub 2021 Nov 2.
- Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022 Oct 29;17(1):75. doi: 10.1186/s13012-022-01245-0.
- Whitehead AL, Julious SA, Cooper CL, Campbell MJ. Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable. Stat Methods Med Res. 2016 Jun;25(3):1057-73. doi: 10.1177/0962280215588241. Epub 2015 Jun 19.
- Christo EM. Novel Applications of Virtual Communities in Healthcare Settings: Chapter 4: Manage My Pain. IGI Global; 2017. 271.
- Development & Usability of a Scalable Digital Psychology Intervention for Chronic Postsurgical Pain - IASP [Internet]. https://posters.worldcongress2024.org/. [cited 2025 Jun 24]. Available from: https://posters.worldcongress2024.org/poster/development-usability-of-a-scalable-digital-psychology-intervention-for-chronic-postsurgical-pain/
- Canadian Pain Task Force Report: March 2021 [Internet]. 2021 [cited 2025 Jun 23]. Available from: https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021.html
- Qureshi AR, Patel M, Neumark S, Wang L, Couban RJ, Sadeghirad B, Bengizi A, Busse JW. Prevalence of chronic non-cancer pain among military veterans: a systematic review and meta-analysis of observational studies. BMJ Mil Health. 2025 Jul 23;171(4):310-314. doi: 10.1136/military-2023-002554.
- Becker WC, Dorflinger L, Edmond SN, Islam L, Heapy AA, Fraenkel L. Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Fam Pract. 2017 Mar 20;18(1):41. doi: 10.1186/s12875-017-0608-2.
- Simmonds MJ, Finley EP, Vale S, Pugh MJ, Turner BJ. A qualitative study of veterans on long-term opioid analgesics: barriers and facilitators to multimodality pain management. Pain Med. 2015 Apr;16(4):726-32. doi: 10.1111/pme.12626. Epub 2014 Dec 19.
- Ul Haq MZ, Ashoorion V, Xi CE, Wang E, Ross N, Parakh N, Busse JW, Darzi AJ, Alvarez E. Canadian Veterans' Experiences of Living with Chronic Pain: A Descriptive Qualitative Study. Can J Pain. 2024 Jun 10;8(2):2361006. doi: 10.1080/24740527.2024.2361006. eCollection 2024.
- King AC, Zahrai A, Bisson EJ, Shergill Y, Rice D, Wai E, Nedden NZ, Cooper L, James D, Rash JA, Bosma R, Ramsay T, Poulin P. Implementation-effectiveness of the power over pain portal for patients awaiting a tertiary care consultation for chronic pain: A pilot feasibility study. Digit Health. 2025 Mar 17;11:20552076251326229. doi: 10.1177/20552076251326229. eCollection 2025 Jan-Dec.
- Thurnheer SE, Gravestock I, Pichierri G, Steurer J, Burgstaller JM. Benefits of Mobile Apps in Pain Management: Systematic Review. JMIR Mhealth Uhealth. 2018 Oct 22;6(10):e11231. doi: 10.2196/11231.
- Pearson R, Carl E, Creech SK. Computerized Psychological Interventions in Veterans and Service Members: Systematic Review of Randomized Controlled Trials. J Med Internet Res. 2022 Jun 3;24(6):e30065. doi: 10.2196/30065.
- Kroll-Desrosiers A, Finley EP, Hamilton AB, Cabassa LJ. Evidence-Based Intervention Adaptations Within the Veterans Health Administration: a Scoping Review. J Gen Intern Med. 2023 Aug;38(10):2383-2395. doi: 10.1007/s11606-023-08218-z. Epub 2023 May 30.
- Bhatia A, Kara J, Janmohamed T, Prabhu A, Lebovic G, Katz J, Clarke H. User Engagement and Clinical Impact of the Manage My Pain App in Patients With Chronic Pain: A Real-World, Multi-site Trial. JMIR Mhealth Uhealth. 2021 Mar 4;9(3):e26528. doi: 10.2196/26528.
- Slepian PM, Peng M, Janmohamed T, Kotteeswaran Y, Manoo V, Blades AM, Fiorellino J, Katznelson R, Tamir D, McRae K, Kahn M, Huang A, Kona S, Thaker S, Weinrib A, Katz J, Clarke H. Engagement with Manage My Pain mobile health application among patients at the Transitional Pain Service. Digit Health. 2020 Oct 13;6:2055207620962297. doi: 10.1177/2055207620962297. eCollection 2020 Jan-Dec.
- Scott W, McCracken LM. Psychological flexibility, acceptance and commitment therapy, and chronic pain. Curr Opin Psychol. 2015 Apr 1;2:91-6.
- Wang JQ, Wang XZ, Wang WX. Acceptance and commitment therapy for enhancing mental health in military personnel: A comprehensive review and meta-analysis. World J Psychiatry. 2025 Mar 19;15(3):100959. doi: 10.5498/wjp.v15.i3.100959. eCollection 2025 Mar 19.
- Donahue ML, Fruge JE, Andresen FJ, Twohig MP. Acceptance and commitment therapy (ACT) among U.S. veterans: A systematic review. J Context Behav Sci. 2024 Apr 1;32:100731.
- Bell ML, Whitehead AL, Julious SA. Guidance for using pilot studies to inform the design of intervention trials with continuous outcomes. Clin Epidemiol. 2018 Jan 18;10:153-157. doi: 10.2147/CLEP.S146397. eCollection 2018.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (估计的)
2026年9月14日
初级完成 (估计的)
2027年9月1日
研究完成 (估计的)
2027年9月30日
研究注册日期
首次提交
2026年8月26日
首先提交符合 QC 标准的
2026年9月11日
首次发布 (实际的)
2026年9月14日
研究记录更新
最后更新发布 (实际的)
2026年9月18日
上次提交的符合 QC 标准的更新
2026年9月15日
最后验证
2026年8月1日
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- 26-5032
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
不
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研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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