Pain Smart: Integrating pain education and case management for adolescents with pain at schools. Part 1 of a Protocol for a Combined Cluster Randomised Controlled Trial and Individually-Randomised Controlled Trial.

Pain education module vs. No Pain education module The Pain Smart education module includes evidence-based information about pain and pain management aligned with the biopsychosocial model of pain. The development of the module was informed by interviews and a survey of Australian adolescents to explore what they know about pain and their preferences for learning about pain at school. The findings from these studies were integrated with current scientific information about pain to develop the education module. We collaborated with education specialists with expertise in curriculum development to align content with the NSW PDHPE curriculum and mapped the module to the current NSW PDHPE syllabus. The education module was piloted in 312 students in grades 8-10 and 9 PDHPE teachers at two Australian secondary schools. The Pain Smart education module includes three one-hour lessons about pain and pain management: 1) understanding pain and its impact, 2) impact of pain on the whole person, and 3) smart and healthy ways to manage pain. Based on feedback from the feasibility study, we developed a four-lesson option to allocate more time to understanding the biopsychosocial model and applying it to pain. The Pain Smart education module is general in nature with no individual content. The module will be embedded in the curriculum and delivered to the students by PDHPE teachers during usual PDHPE classes once per week over three or four weeks (depending on the three or four lesson version, according to school preferences). The teachers will receive an education module package from the study investigators including: three or four PowerPoint presentations (one for each lesson), a student workbook, a teacher handbook and a module outline aligning content with learning outcomes in stages 4 and 5 of the NSW PDHPE curriculum. Teachers will participate in a 1-hour training session with the study investigators prior to delivering the lessons about pain education and biopsychosocial management for pain. This will ensure all teachers understand the content and deliver the module as intended. The learning activities align with the Interactive-Constructive-Active-Passive Framework for cognitive engagement in learning which suggests learning increases with greater engagement in learning materials. For example, activities include watching an educational video and taking notes followed by a guided class discussion, and working in pairs to read case studies about pain, identify biopsychosocial factors in each case study and compare the case studies using a Venn diagram. Given parents strongly influence how their children learn to respond to pain, caregivers will be invited to attend information sessions about the study and will receive PDF summary of key concepts from the education module.