Bedree, H., Koven, M., Jagpal, A., & Tran, S. T. (2023, March). RCTs in psychosocial treatment of pediatric chronic pain: Who is included and who is left out? [Poster presentation]. Society for Pediatric Psychology Annual Conference, Chicago, IL.

RCTs in Psychosocial Treatment of Pediatric Chronic Pain: Who Is Included and Who Is Left Out? 

Helen Bedree¹, M.A., Marissa Koven¹, M.A., Anjana Jagpal², Ph.D., & Susan T. Tran¹, Ph.D. 

¹DePaul University, ²Nationwide Children’s Hospital 

Abstract

Introduction: Various sociocultural groups experience pediatric chronic pain, which negatively impacts quality of life and functional disability. While psychological interventions are effective in improving functioning and randomized controlled trials (RCTs) are the “gold standard” of testing treatment efficacy, diverse groups have been underrepresented in RCTs. The current study aimed to determine the rate of inclusion of demographic groups in RCTs examining psychological treatment of pediatric chronic pain.  

Methods: 57 studies from two published systematic reviews of RCTs assessing the efficacy of psychological treatments (remotely and in-person) for pediatric chronic pain were included. Each study was assessed on 1) whether participant demographics (race, ethnicity, gender, and socioeconomic status) were reported and 2) who was included. Each article was double coded by a team of three researchers.  

Results: The most prevalent pain conditions included were migraine/headache (45.61%), disorders of the gut-brain interaction (14.04%), and recurrent abdominal pain (12.28%). Less than half of the studies reported on race (38.60%). Within those studies, participants were 69.92% White, 9.08% Black/African American, 7.73% Non-Specified, 3.42% Multiracial, 0.81% Asian American, 0.54% Native American/American Indian/Native Alaskan, and 0.13% Native Hawaiian or other Pacific Islander. Of the studies that reported on ethnicity (15.79%), 55.46% Non-Latinx/Hispanic, 44.25% Non-Specified, and 6.65% Latinx/Hispanic individuals were included. All studies reported on sex or gender, using terms gender (42%) and sex (40%) almost equally, with most having a higher percentage of female participants. About half of the studies (43.86%) reported on socioeconomic status, and of those, parent education was the predominant indicator (76%).  

Conclusions: The current study suggests that RCTs fail to include diverse samples and use inconsistent measurement of sociodemographic variables. Therefore, standards for measuring these important identity characteristics and increased recruitment of diverse samples are needed to best serve pediatric chronic pain populations with effective psychosocial treatments. 

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