{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T06:46:57Z","timestamp":1775112417731,"version":"3.50.1"},"reference-count":65,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:p>Chronic pain in adolescents is an increasing public health concern with a significant physical, psychological, and social impact. This study aims to develop, implement, and evaluate DigiDOL-Ad, a digital psychosocial treatment for adolescents with chronic pain, supplemented by dedicated websites for their parents and teachers. This multicenter study will be conducted in four phases: (1) Development of the intervention framework and foundational planning; (2) Focus groups with adolescents with chronic pain, their parents, teachers, healthcare professionals and health authorities to identify specific needs and tailor the psychosocial treatment and related components; (3) Iterative usability testing of the digital treatment, using an a hermeneutical circle methodology to refine the design based on participant feedback; and (4) Evaluation of DigiDOL-Ad through a pre-treatment, post-treatment, and 3-month follow-up assessment. DigiDOL-Ad has the potential to improve the quality of life for adolescents with chronic pain. By leveraging digital health technologies, this innovative approach could establish a new benchmark for treating adolescents with chronic pain, emphasizing interdisciplinary and stakeholder-driven care.<\/jats:p><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:uri>clinicaltrials.gov<\/jats:uri>, identifier NCT06765200.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fdgth.2025.1555733","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T05:36:57Z","timestamp":1749015417000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Development, implementation and evaluation of a digital treatment for adolescents with chronic pain: a protocol for a multi-phase study"],"prefix":"10.3389","volume":"7","author":[{"given":"Jordi","family":"Mir\u00f3","sequence":"first","affiliation":[]},{"given":"Ariadna","family":"Sampietro","sequence":"additional","affiliation":[]},{"given":"Sonia","family":"Monterde","sequence":"additional","affiliation":[]},{"given":"Pablo","family":"Ingelmo","sequence":"additional","affiliation":[]},{"given":"Rikard K.","family":"Wicksell","sequence":"additional","affiliation":[]},{"given":"Carme","family":"Nolla","sequence":"additional","affiliation":[]},{"given":"Mercedes","family":"Alonso","sequence":"additional","affiliation":[]},{"given":"Juan Jos\u00e9","family":"L\u00e1zaro","sequence":"additional","affiliation":[]},{"given":"Ernesto","family":"Mart\u00ednez","sequence":"additional","affiliation":[]},{"given":"Paloma","family":"Rubio","sequence":"additional","affiliation":[]},{"given":"Armando","family":"S\u00e1nchez","sequence":"additional","affiliation":[]},{"given":"Vanessa","family":"S\u00e1nchez","sequence":"additional","affiliation":[]},{"given":"Alvaro","family":"V\u00e1zquez","sequence":"additional","affiliation":[]},{"given":"Roc\u00edo","family":"de la Vega","sequence":"additional","affiliation":[]},{"given":"Francisco","family":"Reinoso-Barbero","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1016\/j.jpain.2022.12.007","article-title":"Chronic pain and high impact chronic pain in children and adolescents: a cross-sectional study","volume":"24","author":"Mir\u00f3","year":"2023","journal-title":"J Pain"},{"key":"B2","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.jpain.2021.07.002","article-title":"Cross-national trends of chronic back pain in adolescents: results from the HBSC study, 2001\u20132014","volume":"23","author":"Roy","year":"2022","journal-title":"J Pain"},{"key":"B3","doi-asserted-by":"publisher","first-page":"2606","DOI":"10.1097\/j.pain.0000000000002965","article-title":"Validation of the pediatric version of the graded chronic pain scale revised in school-aged children and adolescents","volume":"164","author":"Roman-Juan","year":"2023","journal-title":"Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1097\/j.pain.0000000000003267","article-title":"The prevalence of chronic pain in children and adolescents: a systematic review update and meta-analysis","volume":"165","author":"Chambers","year":"2024","journal-title":"Pain"},{"key":"B5","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1016\/j.jpain.2007.10.015","article-title":"The severity of chronic pediatric pain: an epidemiological study","volume":"9","author":"Huguet","year":"2008","journal-title":"J Pain"},{"key":"B6","doi-asserted-by":"publisher","first-page":"pnab333","DOI":"10.1093\/pm\/pnab333","article-title":"The associations between sleep disturbance, psychological dysfunction, pain intensity, and pain interference in children with chronic pain","volume":"23","author":"Sol\u00e9","year":"2021","journal-title":"Pain Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1097\/AJP.0000000000000895","article-title":"Executive functioning in youth with and without chronic pain: a comparative analysis","volume":"37","author":"Turner","year":"2021","journal-title":"Clin J Pain"},{"key":"B8","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1097\/AJP.0000000000000850","article-title":"Impaired school functioning in children with chronic pain: a national perspective","volume":"36","author":"Groenewald","year":"2020","journal-title":"Clin J Pain"},{"key":"B9","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1093\/jpepsy\/jsad014","article-title":"Perceptions of adolescents with chronic pain about peer support: reflexive thematic analysis","volume":"48","author":"Linkiewich","year":"2023","journal-title":"J Pediatr Psychol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1080\/09638288.2017.1400594","article-title":"The role of perceived family social support and parental solicitous responses in adjustment to bothersome pain in young people with physical disabilities","volume":"41","author":"Mir\u00f3","year":"2019","journal-title":"Disabil Rehabil"},{"key":"B11","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/S2352-4642(20)30277-7","article-title":"Delivering transformative action in paediatric pain: a lancet child & adolescent health commission","volume":"5","author":"Eccleston","year":"2021","journal-title":"Lancet Child Adolesc Health"},{"key":"B12","volume-title":"Guidelines on the Management of Chronic Pain in Children","year":"2020"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1390736","DOI":"10.3389\/fpain.2024.1390736","article-title":"Pediatric pain physician workforce: an assessment of supply and demand","volume":"5","author":"Theriault","year":"2024","journal-title":"Front Pain Res"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2484","DOI":"10.3390\/ijerph20032484","article-title":"The treatment of pediatric pain in Spain: a survey study","volume":"20","author":"Mir\u00f3","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1080\/03007995.2020.1854208","article-title":"The management of pediatric chronic pain in Spain: a web-based survey study","volume":"37","author":"Mir\u00f3","year":"2020","journal-title":"Curr Med Res Opin"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2017\/8769402","article-title":"Chronic pain in children: a look at the referral process to a pediatric pain clinic","volume":"2017","author":"Cucchiaro","year":"2018","journal-title":"Int J Pediatr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e613","DOI":"10.1097\/PR9.0000000000000613","article-title":"Pediatric chronic pain programs: current and ideal practice","volume":"2","author":"Mir\u00f3","year":"2017","journal-title":"Pain Rep"},{"key":"B18","volume-title":"Global Strategy on Digital Health 2020\u20132025","year":"2021"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e35159","DOI":"10.2196\/35159","article-title":"Digital health interventions for delivery of mental health care: systematic and comprehensive meta-review","volume":"9","author":"Philippe","year":"2022","journal-title":"JMIR Ment Health"},{"key":"B20","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/j.pain.0000000000003348","article-title":"Digital therapeutics and behavioral chronic pain management: closing the gap between innovation and effective use","volume":"166","author":"Eccleston","year":"2024","journal-title":"Pain"},{"key":"B21","doi-asserted-by":"publisher","first-page":"850601","DOI":"10.3389\/fdgth.2022.850601","article-title":"A systematic review and meta-analysis of digital application use in clinical research in pain medicine","volume":"4","author":"Shetty","year":"2022","journal-title":"Front Digit Health"},{"key":"B22","first-page":"356","article-title":"Mobile devices and apps for health care professionals: uses and benefits","volume":"39","author":"Ventola","year":"2014","journal-title":"P T"},{"key":"B23","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1177\/1359105316650509","article-title":"Fibroline: a mobile app for improving the quality of life of young people with fibromyalgia","volume":"23","author":"de la Vega","year":"2018","journal-title":"J Health Psychol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e26471","DOI":"10.2196\/26471","article-title":"Assessing the quality of mobile health-related apps: interrater reliability study of two guides","volume":"9","author":"Mir\u00f3","year":"2021","journal-title":"JMIR MHealth UHealth"},{"key":"B25","doi-asserted-by":"publisher","first-page":"200","DOI":"10.7326\/0003-4819-158-3-201302050-00583","article-title":"SPIRIT 2013 statement: defining standard protocol items for clinical trials","volume":"158","author":"Chan","year":"2013","journal-title":"Ann Intern Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"104705","DOI":"10.1016\/j.ijnurstu.2024.104705","article-title":"A new framework for developing and evaluating complex interventions: update of medical research council guidance","volume":"154","author":"Skivington","year":"2024","journal-title":"Int J Nurs Stud"},{"key":"B27","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/2159676X.2019.1704846","article-title":"To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales","volume":"13","author":"Braun","year":"2019","journal-title":"Qual Res Sport Exerc Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.jpain.2014.04.009","article-title":"Development and testing of painometer: a smartphone app to assess pain intensity","volume":"15","author":"de la Vega","year":"2014","journal-title":"J Pain"},{"key":"B29","doi-asserted-by":"publisher","first-page":"112","DOI":"10.20986\/resed.2017.3555\/2016","article-title":"Painometer v2\u00ae: una aplicaci\u00f3n m\u00f3vil certificada para monitorizar a los pacientes con dolor","volume":"25","author":"Mir\u00f3","year":"2017","journal-title":"Rev Soc Esp Dolor"},{"key":"B30","doi-asserted-by":"publisher","first-page":"12026","DOI":"10.3390\/ijerph191912026","article-title":"A mobile application to help self-manage pain severity, anxiety, and depressive symptoms in patients with fibromyalgia syndrome: a pilot study","volume":"19","author":"Mir\u00f3","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B31","doi-asserted-by":"publisher","first-page":"e13057","DOI":"10.2196\/13057","article-title":"Standards for mobile health-related apps: systematic review and development of a guide","volume":"8","author":"Llorens-Vernet","year":"2020","journal-title":"JMIR MHealth UHealth"},{"key":"B32","doi-asserted-by":"publisher","first-page":"e17760","DOI":"10.2196\/17760","article-title":"The mobile app development and assessment guide (MAG): Delphi-based validity study","volume":"8","author":"Llorens-Vernet","year":"2020","journal-title":"JMIR MHealth UHealth"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1982","DOI":"10.1111\/pme.12859","article-title":"AN APP for the assessment of pain intensity: validity properties and agreement of pain reports when used with young people","volume":"16","author":"S\u00e1nchez-Rodr\u00edguez","year":"2015","journal-title":"Pain Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"B35","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/j.pain.0000000000001384","article-title":"Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"key":"B36","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1017\/cts.2020.30","article-title":"A REDCap-based model for electronic consent (eConsent): moving toward a more personalized consent","volume":"4","author":"Lawrence","year":"2020","journal-title":"J Clin Transl Sci"},{"key":"B37","doi-asserted-by":"publisher","first-page":"2763","DOI":"10.1097\/j.pain.0000000000001994","article-title":"A digital health psychological intervention (WebMAP Mobile) for children and adolescents with chronic pain: results of a hybrid effectiveness-implementation stepped-wedge cluster randomized trial","volume":"161","author":"Palermo","year":"2020","journal-title":"Pain"},{"key":"B38","doi-asserted-by":"publisher","first-page":"2539","DOI":"10.1097\/j.pain.0000000000002241","article-title":"Core outcome set for pediatric chronic pain clinical trials: results from a Delphi poll and consensus meeting","volume":"162","author":"Palermo","year":"2021","journal-title":"Pain"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1097\/j.pain.0000000000003105","article-title":"Updated recommendations on measures for clinical trials in pediatric chronic pain: a multiphase approach from the core outcomes in pediatric persistent pain (core-OPPP) workgroup","volume":"165","author":"Palermo","year":"2024","journal-title":"Pain"},{"key":"B40","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1097\/AJP.0000000000000406","article-title":"Psychometric properties of the numerical rating scale to assess self-reported pain intensity in children and adolescents: a systematic review","volume":"33","author":"Castarlenas","year":"2017","journal-title":"Clin J Pain"},{"key":"B41","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1016\/j.jpain.2010.02.005","article-title":"PROMIS pediatric pain interference scale: an item response theory analysis of the pediatric pain item bank","volume":"11","author":"Varni","year":"2010","journal-title":"J Pain"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1226037","DOI":"10.3389\/fmed.2023.1226037","article-title":"Psychometric properties of the translated Spanish version of the pain self-efficacy questionnaire","volume":"10","author":"Perez-Dominguez","year":"2023","journal-title":"Front Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1016\/j.jpain.2020.03.004","article-title":"The concerns about pain (CAP) scale: a patient-reported outcome measure of pain catastrophizing","volume":"21","author":"Amtmann","year":"2020","journal-title":"J Pain"},{"key":"B44","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.sjpain.2015.11.010","article-title":"The survey of pain attitudes: a revised version of its pediatric form","volume":"11","author":"Mir\u00f3","year":"2016","journal-title":"Scand J Pain"},{"key":"B45","doi-asserted-by":"publisher","first-page":"2451","DOI":"10.1080\/09638288.2018.1467969","article-title":"Psychometric properties of the functional disability inventory for assessing pain-related disability in children from the community","volume":"41","author":"Sol\u00e9","year":"2019","journal-title":"Disabil Rehabil"},{"key":"B46","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1007\/s11136-013-0544-0","article-title":"Psychometric properties of the PROMIS\u00ae pediatric scales: precision, stability, and comparison of different scoring and administration options","volume":"23","author":"Varni","year":"2014","journal-title":"Qual Life Res"},{"key":"B47","doi-asserted-by":"publisher","first-page":"zsy054","DOI":"10.1093\/sleep\/zsy054","article-title":"Development and validation of the PROMIS pediatric sleep disturbance and sleep-related impairment item banks","volume":"41","author":"Forrest","year":"2018","journal-title":"Sleep"},{"key":"B48","doi-asserted-by":"publisher","first-page":"6408","DOI":"10.1080\/09638288.2021.1964621","article-title":"The silhouettes fatigue scale: a validity study with individuals with physical disabilities and chronic pain","volume":"44","author":"Mir\u00f3","year":"2022","journal-title":"Disabil Rehabil"},{"key":"B49","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/AJP.0b013e3182851735","article-title":"Treatment expectations among adolescents with chronic musculoskeletal pain and their parents before an initial pain clinic evaluation","volume":"30","author":"Guite","year":"2014","journal-title":"Clin J Pain"},{"key":"B50","doi-asserted-by":"publisher","first-page":"e42399","DOI":"10.2196\/42399","article-title":"Mediating role of treatment perceptions in the relationship between individual characteristics and engagement with a digital psychological intervention for pediatric chronic pain: secondary data analysis","volume":"6","author":"de la Vega","year":"2023","journal-title":"JMIR Pediatr Parent"},{"key":"B51","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1097\/AJP.0000000000000600","article-title":"Satisfaction with an intensive interdisciplinary pain treatment for children and adolescents: an independent outcome measure?","volume":"34","author":"Stahlschmidt","year":"2018","journal-title":"Clin J Pain"},{"key":"B52","doi-asserted-by":"publisher","first-page":"jsae099","DOI":"10.1093\/jpepsy\/jsae099","article-title":"Unwanted or negative treatment reactions in digital psychological interventions for adolescents with chronic pain","author":"de la Vega","year":"2024","journal-title":"J Pediatr Psychol"},{"key":"B53","doi-asserted-by":"publisher","first-page":"931","DOI":"10.1093\/jpepsy\/jsad063","article-title":"Adverse childhood events and chronic pain in adolescents: the role of sleep disturbance","volume":"48","author":"Roman-Juan","year":"2023","journal-title":"J Pediatr Psychol"},{"key":"B54","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.jpain.2023.09.004","article-title":"Increases in sleep difficulties and psychological symptoms are associated with the increase of chronic back pain in adolescents: the HBSC study 2002 to 2018","volume":"25","author":"Roman-Juan","year":"2024","journal-title":"J Pain"},{"key":"B55","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1002\/ejp.2003","article-title":"The explanatory role of sedentary screen time and obesity in the increase of chronic back pain amongst European adolescents: the HBSC study 2002\u20132014","volume":"26","author":"Roman-Juan","year":"2022","journal-title":"Eur J Pain"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1097\/j.pain.0000000000003118","article-title":"School bullying and peer relationships in children with chronic pain","volume":"165","author":"Sol\u00e9","year":"2024","journal-title":"Pain"},{"key":"B57","doi-asserted-by":"publisher","first-page":"CD011118","DOI":"10.1002\/14651858.CD011118.pub3","article-title":"Psychological therapies (remotely delivered) for the management of chronic and recurrent pain in children and adolescents","volume":"4","author":"Fisher","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"B58","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1097\/AJP.0000000000000701","article-title":"School absence associated with childhood pain in the United States","volume":"35","author":"Groenewald","year":"2019","journal-title":"Clin J Pain"},{"key":"B59","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1093\/jpepsy\/jsx063","article-title":"School self-concept in adolescents with chronic pain","volume":"42","author":"Logan","year":"2017","journal-title":"J Pediatr Psychol"},{"key":"B60","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/AJP.0000000000000906","article-title":"Video-based pain education in schools: a study with adolescents","volume":"37","author":"Mart\u00ed","year":"2021","journal-title":"Clin J Pain"},{"key":"B61","doi-asserted-by":"publisher","first-page":"4510","DOI":"10.3390\/su13084510","article-title":"Educational needs and resources for teachers working with students with chronic pain: results of a Delphi study","volume":"13","author":"Castarlenas","year":"2021","journal-title":"Sustainability"},{"key":"B62","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1111\/josh.12582","article-title":"Chronic pain in the school setting: the Teachers\u2019 point of view","volume":"88","author":"Sol\u00e9","year":"2018","journal-title":"J Sch Health"},{"key":"B63","doi-asserted-by":"publisher","first-page":"11306","DOI":"10.3390\/ijerph182111306","article-title":"Knowledge of low back pain among primary school teachers","volume":"18","author":"Vidal-Conti","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B64","first-page":"39","article-title":"Costes del tratamiento del dolor versus su no tratamiento. Aproximaci\u00f3n a la realidad de Portugal y espa\u00f1a","volume":"24","author":"Caram\u00e9s-\u00c1lvarez","year":"2016","journal-title":"Dor"},{"key":"B65","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1002\/ejp.2234","article-title":"The costs of chronic pain\u2014long-term estimates","volume":"28","author":"Stubhaug","year":"2024","journal-title":"Eur J Pain"}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1555733\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T05:36:59Z","timestamp":1749015419000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1555733\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,4]]},"references-count":65,"alternative-id":["10.3389\/fdgth.2025.1555733"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2025.1555733","relation":{},"ISSN":["2673-253X"],"issn-type":[{"value":"2673-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,4]]},"article-number":"1555733"}}