Pain Smart: Integrating pain education and clinical care for adolescents with pain at schools.

Arm 1: Pain education module and parents resources The Pain Smart education module contains evidence-based information about pain aligned with the biopsychosocial model. Module content has been informed by previous studies about adolescents’ understanding of and experiences with pain, and their preferences for learning about pain conducted prior to this study. The module has been designed in collaboration with education specialists to ensure congruence with the NSW Personal Development, Health and Physical Education (PDHPE) curriculum, and mapped to the current NSW PDHPE syllabus. Students in both schools will receive three to four lessons to develop their knowledge and understanding of pain, factors that influence the experience of pain and strategies to manage pain. The pain education will be general in nature with no individual content or tailoring. The delivery of the lessons will be multimodal; including teacher presentations, videos, class discussions, and individual and learning activities designed by an education specialist. The lesson content will be provided by the research team to the PDHPE teachers at participating schools. The PDHPE teachers will deliver the content to the students during usual PDHPE classes, one hour per week, for 4 consecutive weeks during one school term. Given parents strongly influence how their children learn to respond to pain, a PDF summary of key concepts from the education module will be emailed to the parents within the first week of education module. Lesson attendance marked by the teacher will be used to monitor adherence. Arm 2: Pain education module and parents resources + Biopsychosocial Care Students in school B who report pain that impacts their lives at baseline will be contacted by a study case manager. A registered health professional with experience treating chronic pain will serve as a case manager for students who report problems with pain. The intervention will be consistent with the WHO guidelines for management of chronic pain in children; biopsychosocial assessment and management, care given by healthcare providers skilled and experienced in chronic pain, comprehensive and integrated care, and an interdisciplinary, multimodal approach to pain management. The telehealth consults with the case manager for assessment an care will be conducted on a secure videoconferencing platform. It will be at the discretion of the student if their parent is present during the consult. Care will be provided through one 30 min consult per week, over a one-month period (4 weeks) and tailored to individual needs. The case manager will record attendance to monitor adherence. The case manager will: 1. Conduct a biopsychosocial assessment, including screening for serious pathology that requires urgent medical attention and mental health. 2. Provide validation, reassurance and information consistent with the participant’s condition and the pain education module. 3. Use principles of goal setting, cognitive behavioural therapy, and motivational interviewing to help the adolescent recover from their condition and return to usual activities. 4. Refer to other health professionals, specialist services and/or further investigations as required. If pain has resolved by the time the case manager contacts the student, the student declines case management or the case manager assesses the student does not require further follow up, no further management will be provided. Arm 3: No intervention